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

Abstract

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.

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

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

“…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 .…”

Postoperative sore throat: a systematic review

“…The paediatric i‐gel has the same design as the adult device and has potential to cause less postoperative sore throat because there is no cuff inflation. The i‐gel has been compared with the ProSeal LMA laryngeal mask, the LMA laryngeal mask Classic , the LMA laryngeal mask Supreme and the PRO‐Breathe ® silicone disposable SAD (Well Lead Medical Co Ltd, Panyu, China) in both spontaneously breathing and patients who received neuromuscular blockers, but these studies were not sufficiently powered to detect a difference in complication rates. However, Smith and Bailey found that there was no difference in the overall incidence of postoperative sore throat between the i‐gel and different SADs when data were pooled.…”

How do different brands of size 1 laryngeal mask airway compare with face mask ventilation in a dedicated laryngeal mask airway teaching manikin?

“…However one study by Drake-Brockman et al 24 found the PRO-Breathe LMA superior to i-gel LMA in a wide age range of children (0–16 years) with LMA size range of 1.5–3. A study by Lee et al 25 in a lower age range of infants (10 months–5 years) found the Classic LMA had similar leak pressure to the i-gel LMA but longer insertion time.…”