Comparison of i-gel<sup>™</sup> supraglottic device with classic laryngeal mask airway in anesthetized paralyzed children undergoing elective surgery

Das, Bikramjit; Mitra, Subhro; Samanta, Arijit; Vijay, Bhavani S

doi:10.4103/0259-1162.108305

Cited by 7 publications

(13 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Their results suggest the i-gel is rapidly inserted in both manikins and patients by an inexperienced person and compares favourably to other supraglottic airways available. 5 Successful insertion of PLMA and i-gel in the first attempt without statistically significant difference in insertion time was observed in study by Jeon et al 11 Similar finding of successful insertion in first attempt were also observed in studies done by Das et al and Chen et al 18,19 In our study mean pulse rates, systolic and diastolic blood pressure, SpO 2 and EtCO 2 at all points of time interval were comparable and there was no statistically significant difference between the two groups with p value >0.05. Similar findings were observed by Helmy et al, Das et al, Chauhan et al in their study comparing LMA and i gel.…”

Section: -13supporting

confidence: 73%

See 1 more Smart Citation

A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia

2016

View full text Add to dashboard Cite

INTRODUCTIONThe approach of airway has evolved greatly in recent times since development of endotracheal intubation by Mc Evan in 1880 to present day use of modern supraglottic airway. The tracheal intubation requires skill and continuous training and practice and usually requires direct laryngoscopy, which may cause laryngopharyngeal lesions. It also produces reflex sympathetic stimulation and is associated with raised levels of plasma catecholamine, hypertension, tachycardia and myocardial ischemia, depression of myocardial contractility, ventricular arrhythmias and intracranial hypertension. Supraglottic airway devices have been widely used as an alternative to tracheal intubation during general anaesthesia both in adults and children. The first successful supraglottic airway device -laryngeal mask airway (LMA) classic, an inflatable supraglottic airway device became available in 1981.2 I-gel is the most recent development in supraglottic airway devices. It is made of ABSTRACT Background: Supraglottic airway devices have been widely used as an alternative to tracheal intubation during general anesthesia both in adults and children. This study was carried out to compare classical laryngeal mask airway (LMA) and i-gel, regarding ease of insertion, adequate placement of device, ability to maintain ETCO 2 and SPO 2 , perioperative hemodynamic parameters and intra operative and postoperative complication. Methods: This prospective, randomized clinical study was done on 100 patients of either sex, age between 5 to 60 years, ASA grade I-III who underwent different surgical procedures under general anesthesia in supine position. After giving premedication, induction of anesthesia was done with inj. Propofol 2-3 mg/kg and inj. Succnylcoline 1.5-2 mg/kg. In "sniffing air" position, airway was secured with either LMA or i-gel. An effective placement of device was checked by a square wave capnography, normal chest expansion, SPO 2 >95%, and absence of audible leak. Patients were observed for time and ease of insertion, number of attempts, perioperative hemodynamic changes and complications. Results: No statistically significant difference was reported between both the groups, regarding heart rate, BP, SPO 2 and ETCO 2 . Duration of insertion was more in group LMA. Insertion was easy and was possible in first attempt in 88% of patients without much manipulation in group i-gel. Conclusions: I-gel is a better alternative supraglottic airway device than LMA in view of ease of insertion with minimal manipulations and minimal complications. Hemodynamic parameters, SPO 2 and ETCO 2 were maintained in both the groups.

show abstract

Section: -13supporting

confidence: 73%

“…9,12,16,17 Das et al had observed higher number of manipulations to insert LMA than i-gel. 18 In our study device was placed in first attempt in 88% patients of group i-gel compared to 64% of group LMA. In group LMA 12% patient required second attempt and 16% required third attempt.…”

Section: -13mentioning

confidence: 99%

A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia

2016

View full text Add to dashboard Cite

show abstract

“…In the studies by Goyal et al [6] and [10] Unclear Unclear High* Unclear Kus et al [11] Unclear Unclear High* Unclear Gasteiger et al [12] Low Unclear High* Low † Goyal et al [6] Low Unclear High* Unclear Fukuhara et al [13] Low Unclear High* Unclear Das et al [7] Low Unclear High* Unclear Das et al [8] Low Unclear High* Unclear Lee et al [22] Unclear Unclear High* Unclear Theiler et al [18] Low Low High* Low † Tokgoz et al [14] Low Unclear High* Unclear Lee et al [16] Unclear Unclear High* Unclear Kim et al [17] Low Low High* Unclear Mitra et al [15] Low Unclear High* Unclear *Not possible to blind researchers to airway device used. †Intention to treat analysis stated.…”

Section: Oropharyngeal Leak Pressurementioning

confidence: 99%

“…Das et al [7,8] the authors compared the i-gel with two other airway devices and the results have been separated for ease of comparison. Three randomised trials compared the i-gel with the LMA Supreme TM (Teleflex Medical) and included a total of 150 patients.…”

Section: Study Selection Bias Information Bias Measurement Errors Conmentioning

confidence: 99%

See 1 more Smart Citation

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

Smith

Bailey

2014

Anaesthesia

View full text Add to dashboard Cite

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.

show abstract

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

et al. 2017

View full text Add to dashboard Cite

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.

show abstract

Comparison of i-gel^™ supraglottic device with classic laryngeal mask airway in anesthetized paralyzed children undergoing elective surgery

Cited by 7 publications

References 16 publications

A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia

A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia

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

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

Contact Info

Product

Resources

About

Comparison of i-gel™ supraglottic device with classic laryngeal mask airway in anesthetized paralyzed children undergoing elective surgery

Cited by 7 publications

References 16 publications

A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia

A comparative study between i-gel and classical laryngeal mask airway in elective surgery under general anaesthesia

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

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

Contact Info

Product

Resources

About

Comparison of i-gel^™ supraglottic device with classic laryngeal mask airway in anesthetized paralyzed children undergoing elective surgery

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