Online ISSN: 2515-8260

Keywords : supraglottic airway device

Comparison of effectiveness of airway maintenance of ‘I-Gel with proseal LMA’ in elective surgeries in adults

Dr. K Anjana, Dr. R Gowthaman, Dr. SK Srinivasan, Dr. Ragul A

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3498-3511

The Supraglottic airway device is an effective alternative to face mask or endotracheal intubation for maintaining airway. It provides a hands-free means of achieving a secure airway.
Aim: To compare the effectiveness of airway maintenance between I-Gel and Proseal Laryngeal mask airway in elective surgeries in adults with respect to
a)      Time of insertion.
b)      Number of insertion attempts.
c)      Ease of insertion.
d)     Oxygen saturation.
e)      Airway seal pressure.
f)       Airway manipulation, if needed.
g)      Side effects (blood staining of device, tongue, lips and dental trauma and hoarseness of voice).
h)      Possible complications (bronchospasm and laryngospasm).
Materials and Methods: This is a prospective, randomized clinical study. After approval from the Ethics Committee, 60 patients of both genders were screened for eligibility to participate in the study. Written informed consent was obtained from all the patients after thoroughly explaining about the study. Patients were randomly allocated into two groups using a sealed envelope.
Group I (I-Gel, n= 30).
Group P (PLMA, n= 30).
A complete pre-anesthetic evaluation was done and patients were fasted for at least 6hrs for solids and 4hrs for liquids.
After anaesthetic induction, I-Gel or PLMA was inserted. The cuff of the Proseal LMA was inflated with 20ml of air for size 3 and 30ml of air for size 4. The following parameters were compared which include insertion time, ease of insertion, number of insertion attempts, sealing pressure and side effects.
Results: There was no significant difference in demographic and hemodynamic data. The mean insertion time was found to be more in PLMA (14.43±2.41 seconds), the ease of insertion was better in I-Gel (93.3%) and airway seal pressure was more in PLMA (24.87±1.79cm H2O).
Conclusion: Based on the results of our study, we conclude that I-Gel aids easy and rapid insertion with an acceptable airway sealing pressure. I-Gel when compared to PLMA hassles insertion time and less post-operative complications. Hence, I-Gel can be a very good alternative to PLMA.

Evaluation of the Efficacy of I-gel Supraglottic Airway Device in Relation to Ease of Insertion, Time Taken to Establish Effective Ventilation and Gastric Insufflation

Akhilesh Mishra, Vineet Mishra, Vrushali Moharil, Abha Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5712-5718

Introduction: I-gel is a novel supraglottic airway device with anatomically designed,
non-inflatable mask, which is soft gel like and transparent made of medical grade
thermoplastic elastomer called styrene ethylene butadiene styrene.The present study is
carried out to evaluate the efficacy of I-gel with regard to easiness of insertion of I-gel,
number of insertion attempts, time taken and maneuvers required; time taken to
establish effective ventilation and gastric insufflation.
Material and Methods: A prospective randomized controlled study was conducted on 40
patients scheduled for elective surgical procedures and requiring controlled ventilation.
Patients were induced with thiopentone 4-6 mg/kg. Size 3 I-gel was used in patients
weighing 30-60 kg and size 4 I-gel was used in patients weighing 60-90 kg. Correct I-gel
insertion was assessed clinically by subjective assessment of appropriate length of
airway tube outside the mouth, gastric insufflation and adequacy of manual ventilation
which was assessed by proper chest expansion and presence of CO2 waveform.
Results: The study included the patients with MMP classI/II and ASA grade I/II. The
mean time taken for insertion was 14.75±1.48 seconds and 95% patients required single
attempt for successful device insertion and 5% patients required second attempt for
successful device insertion. In two patients head tilt and chin lift maneuver was used for
the correct placement of the device.In 38(95%) patients the insertion of the I-gel was
scores very easy(grade1) and in 2(5%) patients it was scored easy(grade 2).
Conclusion: I-gel is an effective supraglottic airway device which can be rapidly
inserted. It provides a leak free glottis seal during positive pressure ventilation. The
nasogastric tube can be easily placed