A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices

Abstract

SummaryWe performed a review of published literature comparing the i‐gel™ with other supraglottic airway devices in children. Sixty‐two articles were identified following a literature search; we included data from 14 randomised controlled trials and eight observational studies that compared i‐gel sizes 1–2.5 with other commonly used, equivalently‐sized, devices. The primary outcome in most studies was oropharyngeal leak pressure. In the 14 randomised trials the i‐gel performed the same as the comparator device in five trials, significantly better in eight studies (p < 0.05) and significantly worse in one (p < 0.01). Seven studies assessed fibreoptic views of the larynx through the device; two found significantly better views through the i‐gel. Three studies reported a shorter insertion time for the i‐gel, whereas two reported a longer time. Insertion success rate, gastric tube placement and complications were similar for all the devices. Seven of the eight observational studies measured average oropharyngeal leak pressures of 20–27 cmH2O and all had first‐time insertion success rates exceeding 90%. We conclude that the i‐gel is at least equivalent to other supraglottic airway devices currently available for use in children, and may enable a higher oropharyngeal leak pressure and an improved fibreoptic view of the glottis.

A randomised comparison of the Ambu® AuraGain™ and the LMA® supreme in infants and children

“…The initial airway leak pressures in this study for the AuraGain are similar to previous studies with the LMA Supreme [1,5,6,12], but slightly lower than the reported airway leak pressures of the LMA ProSeal [2,13] and i-gel [14][15][16] in children. The slight increase in airway leak pressures at 10 min in this study is suggestive that the airway sealing characteristics remain relatively stable during the initial phase of anaesthetic maintenance.…”

Which supraglottic airway will serve my patient best?

“…, Montblanc et al. , Smith & Bailey , and Baidya et al. , may help distill what clinical evidence we do have and identify outcomes for which there is still insufficient evidence.…”

“…In the era of evidence‐based medicine, introduction of a new device into clinical practice must be justified first with scientific reasoning. In this and recent issues of Anaesthesia , such evidence is provided by way of three meta‐analyses on the i‐gel ® and one on the Ambu ® AuraOnce ™ .…”

The design of the perfect pediatric supraglottic airway device

“…The i‐gel may have a slight advantage in practicality since institutions may be less inclined to use reusable devices, such as the ProSeal. Furthermore, the i‐gel's mask material of thermoplastic elastomer that adapts to the shape of the patient's pharynx creates a superior seal compared to many other devices, including the Laryngeal Mask Airway Classic and Laryngeal Mask Airway Unique, Supreme, and ProSeal . The i‐gel's additional advantage is that its mask does not involve a cuff that can be inflated.…”