Evaluation of I‐Gel<sup>™</sup> size 2 airway in different degrees of neck flexion in anesthetized children – a prospective, self‐controlled trial

Jain, Divya; Ghai, Babita; Gandhi, Komal; Banerjee, Gargi; Bala, Indu; Samujh, Ram

doi:10.1111/pan.13001

Cited by 6 publications

(17 citation statements)

References 16 publications

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“…SADs used for the included studies were as follows: the air-Q self-pressurizing airway was used in 1 study,[4] the i-gel was used in 5 studies,[10–12,14,23] the LMA Supreme was used in 2 studies,[6,23] the laryngeal tube was used in 1 study,[9] the laryngeal tube suction was used in 4 studies,[6,8,17,24] the LMA Proseal was used in 6 studies,[8,11,15,16,24,25] the Cobra perilaryngeal airway was used in 1 study,[8] the LMA Classic was used in 5 studies,[5,7,9,13,25] and the LMA Flexible was used in 2 studies. [7,13] The reinforced LMA was regarded as the LMA Flexible.…”

Section: Resultsmentioning

confidence: 99%

“…[4,8] Because the pharyngeal anatomy changes according to the head and neck position, the performance of SADs may be affected, including the sealing function, ventilation, and fibreoptic view. [4,9–12]…”

Section: Introductionmentioning

confidence: 99%

“…[1,4,9,13,14] Although the design of most SADs is generally based on the LMA Classic, each device has its own unique structural characteristics. [4,8,12,15] In addition, newer SADs, such as the i-gel and the air-Q self-pressurizing airway, do not require cuff inflation. [4,14]…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported changes in SAD performance according to head and neck position but with conflicting results. [4,12,16,17] Therefore, this systematic review and meta-analysis aimed to integrate the existing data to elucidate the effect of head and neck position on the overall performance of SADs, as well as the performance of individual devices.…”

Section: Introductionmentioning

confidence: 99%

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Influence of head and neck position on the performance of supraglottic airway devices: A systematic review and meta-analysis

et al. 2019

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Background Changes in head and neck position may significantly affect the performance of supraglottic airway devices (SADs) by altering the pharyngeal structure. Purpose This systematic review and meta-analysis aimed to elucidate the effect of changes in head and neck position on performance of SADs. Data source Bibliographic databases, including PubMed, EMBASE, the Cochrane library, and the Web of Science. Study eligibility criteria Prospective studies investigating the effects of head and neck positions on the performance of SADs. Methods A random effect model was applied in the all analyses. Subgroup analysis was performed according to the type of device and the age of patient. The oropharyngeal leak pressure was the primary outcome measure. Secondary outcome measures included peak inspiratory pressure, fibreoptic view, and ventilation score (PROSPERO, CRD42017076971). Results Seventeen studies met the eligibility criteria. Overall, the oropharyngeal leak pressure significantly increased (mean difference 4.07 cmH 2 O; 95% confidence interval 3.30 to 4.84) during neck flexion with adverse effects on ventilation and fibreoptic view. Conversely, the oropharyngeal leak pressure decreased (mean difference − 4.05; 95% confidence interval − 4.90 to − 3.20) during neck extension with no significant effect on ventilation or fibreoptic view. Rotation of the head and neck did not significantly affect SAD performance. Conclusions The reduced oropharyngeal leak pressure in the extended neck position was not associated with impaired ventilation except with the air-Q self-pressurizing airway. The flexed neck position significantly worsens ventilation and the alignment between the SAD and glottis despite improving the seal except with the air-Q self-pressurizing airway and LMA Proseal.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influence of head and neck position on the performance of supraglottic airway devices: A systematic review and meta-analysis

et al. 2019

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“…Sir—With great interest, we read the article entitled ‘Evaluation of I‐Gel™ size 2 airway in different degrees of neck flexion in anesthetized children—a prospective, self‐controlled trial’ . We acknowledge this study is interesting and meaningful for our clinical work.…”

mentioning

confidence: 99%

Comment on: ‘Evaluation of I‐Gel™ size 2 airway in different degrees of neck flexion in anesthetized children—a prospective, self‐controlled trial’

Wang

Wei

2017

Pediatric Anesthesia

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2 Henderson CM, FitzGerald M, Hoehn KS et al. Pediatrician ambiguity in understanding palliative sedation at the end of life. Am J Hospice Palliative Med 2015; 1-15. 3 Gurschick L, Mayer DK, Hanson LC. Palliative sedation: an analysis of international guidelines and position statements. Am J Hosp Palliat Care 2015; 32: 660-671. 4 Johnson LM, Snaman JM, Cupit MC et al. End-of-life care for hospitalized children. Pediatr Clin North Am 2014; 61: 835-854. 5 Anghelescu DL, Faughnan LG, Baker JN et al. Use of epidural and peripheral nerve blocks at the end of life in children and young adults with cancer: the collaboration between a pain service and a palliative care service.SIR-With great interest, we read the article entitled 'Evaluation of I-Gel TM size 2 airway in different degrees of neck flexion in anesthetized children-a prospective, self-controlled trial' (1). We acknowledge this study is interesting and meaningful for our clinical work. Nevertheless, the insertion depth of the laryngeal mask airway has not been described in the paper but may have an effect on the experimental results. As we know, only with adequate depth of laryngeal mask airway insertion can we get a good seal and good tidal ventilation. However, the depth is not precise, it is a range. Within the range, both the attainable peak pressures and the glottic view may vary considerably; moreover, the less depth can result in a better glottic view (2). So different depths may produce different results while positioning the neck flexion at 15°, 30°, and 45°. We wonder if the authors can address the details of the insertion depth. Ethics approvalNo necessary ethics approvals.

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Comparaison de la pression de fuite du dispositif LMA® ProSeal™ par rapport au i-gel® lors de rotation de la tête : une étude randomisée contrôlée

Chaki,

Koizumi,

Tachibana

et al. 2023

Can J Anesth/J Can Anesth

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Evaluation of I‐Gel^™ size 2 airway in different degrees of neck flexion in anesthetized children – a prospective, self‐controlled trial

Cited by 6 publications

References 16 publications

Influence of head and neck position on the performance of supraglottic airway devices: A systematic review and meta-analysis

Influence of head and neck position on the performance of supraglottic airway devices: A systematic review and meta-analysis

Comment on: ‘Evaluation of I‐Gel™ size 2 airway in different degrees of neck flexion in anesthetized children—a prospective, self‐controlled trial’

Comparaison de la pression de fuite du dispositif LMA® ProSeal™ par rapport au i-gel® lors de rotation de la tête : une étude randomisée contrôlée

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Evaluation of I‐Gel™ size 2 airway in different degrees of neck flexion in anesthetized children – a prospective, self‐controlled trial

Cited by 6 publications

References 16 publications

Influence of head and neck position on the performance of supraglottic airway devices: A systematic review and meta-analysis

Influence of head and neck position on the performance of supraglottic airway devices: A systematic review and meta-analysis

Comment on: ‘Evaluation of I‐Gel™ size 2 airway in different degrees of neck flexion in anesthetized children—a prospective, self‐controlled trial’

Comparaison de la pression de fuite du dispositif LMA® ProSeal™ par rapport au i-gel® lors de rotation de la tête : une étude randomisée contrôlée

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Evaluation of I‐Gel^™ size 2 airway in different degrees of neck flexion in anesthetized children – a prospective, self‐controlled trial