Use of the i-gel™ supraglottic airway device in a patient with subglottic stenosis -a case report-

Lee, Ki Hwa; Kang, Eun Su; Jung, Jin Tae; Park, Jae Hong; Choi, Young-Hyun

doi:10.4097/kjae.2013.65.3.254

Cited by 7 publications

(9 citation statements)

References 9 publications

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“…In the field of anesthesia, they are used during spontaneous or intermittent positive pressure ventilation. In intensive care medicine, they are a valuable rescue airway tool in emergency airway management [ 1 – 3 ]. These devices have become indispensable to anesthesiologists [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Both the I-gel (Intersurgical, Wokingham, UK) and the streamlined liner of pharyngeal airway (SLIPA, Medical Ltd., London, UK) are cuffless, anatomically preshaped, perilaryngeal sealers [ 6 , 7 ]. The I-gel has a noninflatable cuff made from a gel-like thermoplastic elastomer (styrene ethylene butadiene styrene) [ 1 ]. This cuff exerts slight pressure on the pharyngolaryngeal structure, providing a perilaryngeal seal with only minimal risk of tissue compression [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study

El-Radaideh

Anesthesiology

Hani

2015

Anesthesiology Research and Practice

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Introduction. This study compared streamlined liner of the pharynx airway (SLIPA) and I-gel noninflatable, single-use, supraglottic airway device (SAD) performance in anesthetized, paralyzed adults. Methods. Eighty adults (ASA physical statuses I–III) who were undergoing elective procedures under general anesthesia with an SAD were enrolled in this prospective, randomized, single-blind study. Subjects were randomly and evenly assigned to the SLIPA or I-gel group for intraoperative airway management. Ease and number of insertions, insertion time, oropharyngeal sealing pressure, hemodynamic response, oxygen saturation (SpO2), end-tidal CO2 (EtCO2), and peri- and postoperative complications were examined. Results. The SLIPA and I-gel devices were successfully inserted in 100% and 95% of subjects, respectively. In two I-gel subjects (5%), ventilation was not possible after two attempts, but a size 55 SLIPA was successfully inserted in both cases. Forty-two and 38 patients were ultimately included in the SLIPA and I-gel groups, respectively. Insertion time was significantly shorter with the SLIPA (11.19 ± 3.03 s) than with the I-gel (15.05 ± 6.37 s, P = 0.003). Oropharyngeal sealing pressure was significantly higher in SLIPA (28.76 ± 3.11 cmH2O) than in I-gel (25.9 ± 3.65 cmH2O) subjects (P = 0.001). Blood staining occurred more frequently in SLIPA (n = 8, 19.0%) than in I-gel (n = 5, 13.2%) patients (P < 0.01). Heart rate, mean arterial blood pressure, SpO2, and EtCO2 were not significantly different between groups. Conclusion. Although blood staining incidence was higher, SLIPA insertion was easier and faster than I-gel insertion. The SLIPA provided better airway sealing pressure. Both devices had similar mechanical ventilation and oxygenation characteristics and comparable hemodynamic stability. Both noninflatable SADs are useful, but SLIPA rapid insertion and good airway sealing make it an effective alternative to the I-gel.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study

El-Radaideh

Anesthesiology

Hani

2015

Anesthesiology Research and Practice

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“…Intubating the trachea with an ETT passing through the LTS remains the preferred method [ 1 ]. However, it may not be always possible, depending on localization and particularly the severity of the stenosis [ 2 ]. ETT could also be placed just ahead of the LTS, but it may result in inadequate ventilation with high peak pressures.…”

Section: Discussionmentioning

confidence: 99%

“…The use of a supraglottic airway (SGA) device has been described in the past [ 3 ] and is a common procedure [ 1 ], especially using the i-gel [ 2 , 4 ]. Indeed, SGA devices have the advantage to be easy to insert and to provide ventilation regardless of the localization of LTS.…”

Section: Discussionmentioning

confidence: 99%

Successful ventilation through a Rüsch intubation guide catheter in severe laryngotracheal stenosis

Regemorter

Potié

Schmitz

et al. 2018

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundProviding adequate ventilation may remain complex in patients with severe proximal laryngotracheal stenosis, especially when the airway is shared with the surgeon during tracheal resection surgery. We describe an effective alternative to standard endotracheal intubation using a Rüsch flexible intubation guide catheter.MethodsIn two patients undergoing tracheal repair surgery, we failed to insert a 5.0 inner diameter endotracheal tube (6.9 mm outer diameter) or a 6.0 mm outer diameter endoscope through the laryngotracheal stenosis. However, using indirect laryngoscopy, a 6.0 outer diameter Rüsch flexible intubation guide catheter was passed successfully through the vocal cords and then through the stenosis. Controlled ventilation was achieved by means of the Rüsch guide, provided with its two large Murphy’s eyes. When the trachea was opened, the Rüsch guide was removed just enough for the surgeons to place a Montandon tracheal tube, at that point taking over ventilation. A 7.0 inner diameter endotracheal cuffed tube had been inserted onto the Rüsch guide and left pending upstream from the vocal cords. Once the posterior tracheal wall was sutured, this endotracheal cuffed tube was slid along the Rüsch guide through the vocal cords with the cuff placed beyond the tracheal sutures.ResultsControlled ventilation through the Rüsch flexible intubation guide catheter showed satisfying and stable ventilatory parameters in both patients. Inspiratory pressures of 25–30 mmHg were enough to reach adequate tidal volumes around 450 ml. End tidal CO2 was kept between 35 and 40 mmHg (PaCO2 showed similar values). Standard endotracheal intubation at the end of the tracheal resection was easy and safe thanks to the Rüsch guide still in place between the vocal cords.ConclusionsWe suggest an effective and reliable method using a Rüsch flexible intubation guide catheter for airway management in patients suffering from laryngotracheal stenosis in the setting of tracheal repair surgery.

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“…Donaldson and Michalek [ 10 ] inserted an i-gel® in a patient with no specific medical history other than having been informed to warn future anesthesiologists of her "small breathing pipe" as observed during her previous anesthesia. Furthermore, Lee et al [ 11 ] ventilated a patient with a previous history of pulmonary tuberculosis and suspicious chest radiography findings in the beach-chair position with an i-gel®. Subglottic stenosis was visualized with a fiberscope through the i-gel® in both cases.…”

Section: Discussionmentioning

confidence: 99%

Failed intubation of an unanticipated postintubation tracheal stenosis: a case report

Youn

Yoon

Park

2016

Korean J Anesthesiol

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Encountering a patient with unanticipated laryngotracheal stenosis (LTS) during anesthetic induction is challenging for an anesthesiologist. Because routine history taking and pre-anesthetic evaluation cannot rule out the possibility of LTS, other measures should be taken. Perioperative airway maintenance is considered crucial for avoiding complications such as airway edema, bleeding, obstruction, collapse, and ultimately respiratory failure and arrest. We report an unanticipated tracheal stenosis discovered during anesthetic induction that hindered endotracheal intubation. Because airway maintenance was difficult, we postponed surgery until determining the cause of the difficult entry, considered possible therapeutic approaches (both anesthetic and surgical), and provided successful surgery with a continuous epidural block.

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Use of the i-gel™ supraglottic airway device in a patient with subglottic stenosis -a case report-

Cited by 7 publications

References 9 publications

Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study

Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study

Successful ventilation through a Rüsch intubation guide catheter in severe laryngotracheal stenosis

Failed intubation of an unanticipated postintubation tracheal stenosis: a case report

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