A systematic review and meta‐analysis of the i‐gel^® vs laryngeal mask airway in children

Abstract

SummaryWe systematically reviewed randomised controlled trials of the i-gel â vs different types of laryngeal mask airway in children. We included nine studies. There was no evidence for differences in: rate of insertion at first attempt; insertion time; ease of insertion; or gastric tube insertion. The mean (95% CI) oropharyngeal leak pressure was 3.29 (2.25-4.34) cmH 2 O higher with the i-gel, p < 0.00001. The relative rate (95% CI) of a good fibreoptic view through the i-gel was 1.10 (1.01-1.19), p = 0.02. There were no significant differences in the rates of complications, except for blood on the airway, relative rate with the i-gel 0.46 (0.23-0.91), p = 0.02. We concluded that the clinical performance of the i-gel and LMA was similar, except for three outcomes that favoured the i-gel.

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.…”

“…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. The 10-min airway leak pressures are similar to the airway leak pressures demonstrated in recent reports on the LMA ProSeal [2,17,18] and igel [1,15,16] in children.…”

A randomized comparison between the i-gel™ and the air-Q™ supraglottic airways when used by anesthesiology trainees as conduits for tracheal intubation in children

“…10,12,25,26 The leak pressures of the i-gel appear to be lower than what has been reported in systematic reviews and meta-analyses in children. 14,15 It is possible that operator inexperience may have contributed to the lower airway leak pressures associated with the i-gel.…”

“…[9][10][11][12][13] The i-gel TM (Intersurgical; Wokingham, UK) is a newer SGA that has been shown to be effective for primary anesthetic maintenance, exhibiting higher airway leak pressures compared with other commonly utilized SGAs in children. 14,15 Additionally, some studies have also found similarly favourable fibreoptic views of the larynx through the igel when compared with other SGAs, 16,17 making it potentially useful for facilitating tracheal intubations. To date, there is a lack of formal studies assessing the i-gel's suitability as a conduit for FOB-guided tracheal intubation in children.…”

The Role of Supraglottic Airways in Pediatric Emergency Medicine

“…In a recent metaanalysis, a notable advantage of the i-gel was its higher airway leak pressures and better fiberoptic views compared with other SGAs in children. 23 Overall, the i-gel has been shown to be an effective SGA for a variety of children including infants. 24,25 Laryngeal Tube…”