A prospective randomised comparison of two insertion methods for i-gel^™placement in anaesthetised paralysed patients: standard vs rotational technique

Abstract

SummaryIn this prospective randomised study, we compared two techniques for i-gel TM insertion. One hundred and eighty-one anaesthetised, paralysed adult patients were randomly allocated into one of two groups. In the standard group (n = 91), the i-gel was inserted using the standard technique. In the rotation group (n = 90), the i-gel was rotated 90°a nticlockwise in the mouth and re-rotated in the hypopharynx to the original alignment. The success rate, insertion time, air leak pressure and complications were assessed. The success rate for insertion at the first attempt was lower for the standard technique, 78 (86%) vs 87 (97%; p = 0.016). The mean (SD) insertion time was longer (26.9 (14.5) s vs 22.4 (10.2) s; p = 0.016) and air leak pressure was lower (22.5 (10.4) cmH 2 O vs 27.1 (9.4) cmH 2 O; p = 0.002) in the standard group. The incidence of bloodstaining was higher with the standard technique (8 (9%) vs 1 (1%); p = 0.034). This study suggests that the rotational technique is superior to the standard technique for i-gel insertion.

Insertion of i-gel™ by the reversed technique improves the success rate and reduces the time taken for its placement: A prospective, randomized, controlled, interventional trial

“…[1] They introduced i-gel™ into the mouth and rotated it 90° counterclockwise. The i-gel™ was the advanced backward, passing the body of the tongue until resistance was felt at the hypopharynx and it was then re-rotated clockwise to the standard orientation, at which point it returned to the midline.…”

Laryngoscopy facilitates successful i-gel insertion by novice doctors: a prospective randomized controlled trial

“…While the advantage of SGDs is their ease of use by novice operators [6], rapid and definite insertion of SGDs for sufficient quality ventilation can be difficult for novice doctors. Many reports have described effective i-gel insertion methods [19,20], but no consensus method currently exists.…”

Calling the patient's own name facilitates recovery from general anaesthesia: a randomised double‐blind trial

“…The effect‐site concentrations were targeted to 4 μg.ml −1 for propofol and 4 ng.ml −1 for remifentanil. After administration of 0.6 mg.kg −1 rocuronium, neuromuscular blockade was monitored with the train‐of‐four response of the adductor pollicis muscle by stimulating the ulnar nerve at 2 Hz for 2 s. At a train‐of‐four count 0 and BIS value < 60, a supraglottic airway (i‐gel ® ; Intersurgical Ltd, Wokingham, UK) was inserted using either a standard or rotational technique . The i‐gel size was determined based on the patient's body weight: size 3 for patients ≤ 50 kg and size 4 if > 50 kg.…”