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Abstracts and Programme, EUROANAESTHESIA 2008: Airway Management

I-gel supraglottic airway and classic laryngeal mask airway - A comparison study

19AP2-7

Janakiraman, C.; Chethan, D. B; Wilkes, A.; Goodwin, N.; Stacey, M.

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European Journal of Anaesthesiology (EJA): May-June 2008 - Volume 25 - Issue - p 240
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Background and Goal of Study: The laryngeal mask (LM) airway is widely used as a routine airway for elective surgery and during cardiopulmonary resuscitation. In the United Kingdom the classic LM airway is included in the Difficult Airway Society guidelines for the management of unanticipated difficult intubations. The I-gel supraglottic airway is a novel single-use device designed to fit the peri-laryngeal structures without the use of an inflatable cuff (1). The object of this study is to test whether the I-gel supraglottic airway is an acceptable alternative to the classic LMA.

Materials and Methods: After local research ethics committee approval and written informed consent, 40 ASA I or II patients undergoing general anaesthesia in whom a LM was considered suitable, were enrolled in this ongoing randomised cross over study (final sample size will be 50).The size of the airway device to be used was based on the patient's body weight according to the manufacturer's recommendation. Success at first attempt (primary outcome), overall success rate, grade of insertion (easy, moderate or difficult), leak pressure and fibre-optically determined grade of the laryngeal view were recorded. Wilcoxon test was used to analyse continuous data and McNemar's test for categorical data.

Results and Discussion:

Table C
Table C:
omparison of I Gel and cLMA. Values are median [interquartile range] and percentage

There is a significant difference in success at first attempt between I-gel and cLMA. A second attempt was needed in 12 patients in the I-gel group - a larger size than the one recommended by the manufacturers was needed in this group to obtain an adequate seal. There was no difference in overall success rate, ease of insertion and laryngeal view obtained. I-gel had a significantly better seal than the cLMA.

Conclusion(s): The I-gel supraglottic airway is an acceptable alternative to cLMA. We recommend the manufacturers to review the sizing guideline of Igel supraglottic airway.

References:

Levitan RM, Kinkle WC: Initial anatomic investigations of the I-gel airway: a novel supraglottic airway without inflatable cuff. Anaesthesia 2005; 60: 1022-6.
© 2008 European Society of Anaesthesiology