A comparative study of Laryngeal Mask Airway size 1 vs i‐gel size 1 in infants undergoing daycare procedures

Pant, Deepanjali; Koul, Archna; Sharma, Bimla; Sood, Jayashree

doi:10.1111/pan.12555

Cited by 16 publications

(16 citation statements)

References 22 publications

(36 reference statements)

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“…Approximately half the published studies in children conclude that the i‐gel provides a greater sealing capacity than a comparison laryngeal mask , which contrasts with our results. Only one of these studies specified that laryngeal mask intracuff pressure should not exceed 40 cmH 2 O, finding mean (SD) oropharyngeal leak pressures of 22.30 (4.72) and 18.05 (1.95) cmH 2 O for a size‐1 i‐gel and laryngeal mask, respectively (p = 0.001).…”

Section: Discussioncontrasting

confidence: 99%

“…A number of randomised trials have compared the i‐gel with the most commonly used supraglottic airway device, the laryngeal mask, in its different variations . However, published studies are inconclusive with regard to oropharyngeal leak pressure; some studies have found that the i‐gel provides a higher leak pressure , whereas others conclude that the i‐gel offers lower , or equivalent, leak pressures . In addition, some of these studies describe practices that are not routine, such as the use of neuromuscular blocking drugs in conjunction with positive pressure ventilation .…”

Section: Introductionmentioning

confidence: 99%

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A comparison of the i‐gel^™ and the PRO‐Breathe^® laryngeal mask during pressure support ventilation in children

et al. 2015

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SummaryMany studies comparing the i-gel TM with laryngeal masks include patients in whom laryngeal mask cuff inflation pressures are higher than recommended, or involve the use of neuromuscular blocking drugs and positive pressure ventilation. We compared the i-gel with the PRO-Breathe â laryngeal mask in anaesthetised, spontaneously breathing children. Two hundred patients aged up to 16 years were randomly allocated to either the i-gel or the PRO-Breathe laryngeal mask. The PRO-Breathe was inflated to an intracuff pressure of 40 cmH 2 O. All patients received pressure support of 10 cmH 2 O and positive end-expiratory pressure of 5 cmH 2 O. Successful insertion at the first attempt was 82% for the i-gel compared with 93% for the PRO-Breathe (p = 0.019). Leakage volume was significantly higher with i-gel sizes 1.5 (p = 0.015), 2 (p = 0.375), 2.5 (p = 0.021) and 3 (p = 0.003) compared with the equivalent-sized PRO-Breathe device. Device dislodgement following successful initial placement was more frequent with the i-gel (5%) compared with the PRO-Breathe laryngeal mask (0%). We conclude that the PRO-Breathe laryngeal mask is superior to the i-gel in terms of leakage volume and device dislodgement.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comparison of the i‐gel^™ and the PRO‐Breathe^® laryngeal mask during pressure support ventilation in children

et al. 2015

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“…The full texts of 118 articles were examined in detail. We included 65 articles in this network meta‐analysis (Fig. ).…”

Section: Resultsmentioning

confidence: 99%

“…The trials had a median (range [IQR]) sample size of 60 (27–240 [53–100]). Sevoflurane was administered for anaesthesia induction in 44 studies . There were eight crossover designed studies .…”

Section: Resultsmentioning

confidence: 99%

A network meta‐analysis of the clinical properties of various types of supraglottic airway device in children

et al. 2017

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We conducted both conventional pairwise and Bayesian network meta-analyses to compare the clinical properties of supraglottic airway devices in children. We searched six databases for randomised clinical trials. Our primary end-points were oropharyngeal leak pressure, risk of insertion failure at first attempt, and blood staining risk. The risk of device failure, defined as the abandonment of the supraglottic airway device and replacement with a tracheal tube or another device, was also analysed. Sixty-five randomised clinical trials with 5823 participants were identified, involving 16 types of supraglottic airway device. Network meta-analysis showed that the i-gel™, Cobra perilaryngeal airway™ and Proseal laryngeal mask airway (LMA -Proseal) showed statistically significant differences in oropharyngeal leak pressure compared with the LMA -Classic, with mean differences (95% credible interval, CrI) of 3.6 (1.9-5.8), 4.6 (1.7-7.6) and 3.4 (2.0-4.8) cmH O, respectively. The i-gel was the only device that significantly reduced the risk of blood staining of the device compared with the LMA-Classic, with an odds ratio (95%CrI) of 0.46 (0.22-0.90). The risk (95%CI) of device failure with the LMA-Classic, LMA -Unique and LMA-Proseal was 0.36% (0.14-0.92%), 0.49% (0.13-1.8%) and 0.50% (0.23-1.1%), respectively, whereas the risk (95%CI) of the i-gel and PRO-Breathe was higher, at 3.4% (2.5-4.7%) and 6.0% (2.8-12.5%), respectively. The risk, expressed as odds ratio (95%CrI), of insertion failure at first attempt, was higher in patients weighing < 10 kg at 5.1 (1.6-20.1). We conclude that the LMA-Proseal may be the best supraglottic airway device for children as it has a high oropharyngeal leak pressure and a low risk of insertion. Although the i-gel has a high oropharyngeal leak pressure and low risk of blood staining of the device, the risk of device failure should be evaluated before its routine use can be recommended.

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“…Hier besteht der den larynxumschließende Anteil aus einem thermoplastischen Elastomer, das durch Körperwärme weicher wird und sich somit der jeweiligen Anatomie anpasst. Diese findet auch bei Kindern zunehmend Einsatz[19,24,33], Studien zur i-gel® sind im Folgenden aber noch nicht berücksichtigt. Ein aus der klinischen Praxis häufig berichtetes Problem scheint die spontane Dislokationstendenz zu sein, die in weiteren Kinderstudien noch evaluiert werden muss.Abgewinkelte, gebogene LM mit vorgeformter L-Form (z.…”

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Interdisziplinär konsentierte Stellungnahme zum Atemwegsmanagement mit supraglottischen Atemwegshilfen in der Kindernotfallmedizin

et al. 2015

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Considering the scientific data and the large clinical experience with the LM in medical routine and emergency situations in children, currently only the LM can be recommended for alternative (i.e. non-intubation) airway management in children. If alternative airway management is part of a local emergency strategy, the LM should be provided in all pediatric sizes (1, 1.5, 2, 2.5, 3, 4 and 5) for prehospital and in-hospital emergency use and all users should be regularly trained in its application.

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A comparative study of Laryngeal Mask Airway size 1 vs i‐gel size 1 in infants undergoing daycare procedures

Cited by 16 publications

References 22 publications

A comparison of the i‐gel^™ and the PRO‐Breathe^® laryngeal mask during pressure support ventilation in children

A comparison of the i‐gel^™ and the PRO‐Breathe^® laryngeal mask during pressure support ventilation in children

A network meta‐analysis of the clinical properties of various types of supraglottic airway device in children

Interdisziplinär konsentierte Stellungnahme zum Atemwegsmanagement mit supraglottischen Atemwegshilfen in der Kindernotfallmedizin

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A comparative study of Laryngeal Mask Airway size 1 vs i‐gel size 1 in infants undergoing daycare procedures

Cited by 16 publications

References 22 publications

A comparison of the i‐gel™ and the PRO‐Breathe® laryngeal mask during pressure support ventilation in children

A comparison of the i‐gel™ and the PRO‐Breathe® laryngeal mask during pressure support ventilation in children

A network meta‐analysis of the clinical properties of various types of supraglottic airway device in children

Interdisziplinär konsentierte Stellungnahme zum Atemwegsmanagement mit supraglottischen Atemwegshilfen in der Kindernotfallmedizin

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A comparison of the i‐gel^™ and the PRO‐Breathe^® laryngeal mask during pressure support ventilation in children

A comparison of the i‐gel^™ and the PRO‐Breathe^® laryngeal mask during pressure support ventilation in children