A comparison of the i-gel with the LMA-Unique in non-paralysed anaesthetised adult patients

[Placement of a bronchial blocker through the I-gel supraglottic airway device for single-lung ventilation: preliminary study]

To describe the use of the I-gel supraglottic airway device when placing a bronchial blocker for single-lung ventilation, as applied in a preliminary study to explore the feasibility of adopting the technique with appropriate, selected patients undergoing certain thoracic surgery procedures. We used the technique for single-lung ventilation in 25 patients who required isolation of a lung for a variety of thoracic surgical procedures. A bronchial blocker was placed under direct visualization through a fiberoptic bronchoscope and the I-gel supraglottic device. The I-gel mask allowed us to establish a reliable, safe seal of the airway. For an anesthetist with sufficient experience in managing a flexible fiberoptic bronchoscope, it was possible to carry out all procedures without remarkable anesthetic or surgical events. Single-lung ventilation achieved by introducing a bronchial blocker through the I-gel supraglottic device can facilitate safe, effective management of selected patients who must undergo certain thoracic surgery procedures.

Comparative study between I-gel, a new supraglottic airway device, and classical laryngeal mask airway in anesthetized spontaneously ventilated patients

OBJECTIVE

To compare two different supraglottic airway devices, the laryngeal mask airway (LMA) and the I-gel, regarding easiness of insertion of the device, leak pressure, gastric insufflation, end tidal CO(2), oxygen saturation, hemodynamic and postoperative complications in anesthetized, spontaneously ventilated adult patients performing different non-emergency surgical procedures.

MATERIALS AND METHODS

The study was carried out as a prospective, randomized, clinical trial among 80 patients who underwent different surgical procedures under general anesthesia with spontaneous ventilation in supine position. They were equally randomized into two groups: I-gel and LMA groups. Both the devices were compared with regard to heart rate, arterial BP, SPO(2), end-tidal CO(2), number and duration of insertion attempts, incidence of gastric insufflation, leak pressure and airway assessment after removal of the device.

RESULTS

No statistically significant difference was reported between both the groups, regarding heart rate, arterial BP, SPO(2) and end-tidal CO(2). The mean duration of insertion attempts was 15.6±4.9 seconds in the I-gel group, while it was 26.2±17.7 seconds in the LMA group. The difference between both the groups regarding duration of insertion attempts was statistically significant (P=0.0023*), while the number of insertion attempts was statistically insignificant between both the study groups (P>0.05). Leak pressure was (25.6±4.9 vs. 21.2±7.7 cm H(2)O) significantly higher among studied patients of the I-gel group (P=0.016*) and the incidence of gastric insufflation was significantly more with LMA group 9 (22.5%) vs. I-gel group (5%) (P=0.016).

CONCLUSION

Both LMA and I-gel do not cause any significant alteration in the hemodynamic status of the patients, end tidal CO(2), and SPO(2). The postoperative complications were not significantly different except nusea and vomiting was statistically significant higher in LMA group (P=0.032). among both LMA and I-gel patients. Insertion of I-gel was significantly easier and more rapid than insertion of LMA. Leak pressure was significantly higher with I-gel than LMA and thus incidence of gastric insufflation was significantly lower with I-gel.