A randomised comparison of the i‐gel™ and the Laryngeal Mask Airway Classic™ in infants

Kim, M. S.; Oh, Jung Tak; Min, Jihee; Lee, Kook Hyun; Lee, J. R.

doi:10.1111/anae.12592

Cited by 30 publications

(67 citation statements)

References 18 publications

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“…[3,4,31] The i-gel can be considered as a reasonable candidate for meeting this requirement due to its noninflatable cuff and design for easy insertion. [32] Meta-analyses to secure evidence for the superiority of the i-gel have been carried out primarily in the field of anesthesia. A meta-analysis of the adult-sized i-gel under general anesthesia demonstrated that the i-gel had a shorter insertion time than other devices.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the i-gel and other supraglottic airways in adult manikin studies

Nam²,

Lee³

et al. 2017

Medicine

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Background:The i-gel has a gel-like cuff composed of thermoplastic elastomer that does not require cuff inflation. As the elimination of cuff inflation may shorten insertion time, the i-gel might be a useful tool in emergency situations requiring prompt airway care. This systematic review and meta-analysis of previous adult manikin studies for inexperienced personnel was performed to compare the i-gel with other supraglottic airways.Methods:We searched PubMed, the Cochrane Library, and EMBASE for eligible randomized controlled trials (RCTs) published before June 2015, including with a crossover design, using the following search terms: “i-gel,” “igel,” “simulation,” “manikin,” “manikins,” “mannequin,” and “mannequins.” The primary outcomes of this review were device insertion time and the first-attempt success rate of insertion.Results:A total of 14 RCTs were included. At the initial assessment without difficult circumstances, the i-gel had a significantly shorter insertion time than the LMA Classic, LMA Fastrach, LMA Proseal, LMA Unique, laryngeal tube, Combitube, and EasyTube. However, a faster insertion time of the i-gel was not observed in comparisons with the LMA Supreme, aura-i, and air-Q. In addition, the i-gel did not show the better results for the insertion success rate when compared to other devices.Conclusion:The findings of this meta-analysis indicated that inexperienced volunteers placed the i-gel more rapidly than other supraglottic airways with the exception of the LMA Supreme, aura-i, and air-Q in manikin studies. However, the quicker insertion time is clinically not relevant. The unapparent advantage regarding the insertion success rate and the inherent limitations of the simulation setting indicated that additional evidence is necessary to confirm these advantages of the i-gel in an emergency setting.

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Section: Discussionmentioning

confidence: 99%

Comparison of the i-gel and other supraglottic airways in adult manikin studies

Nam²,

Lee³

et al. 2017

Medicine

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“…In the studies by Goyal et al [6] and [10] Unclear Unclear High* Unclear Kus et al [11] Unclear Unclear High* Unclear Gasteiger et al [12] Low Unclear High* Low † Goyal et al [6] Low Unclear High* Unclear Fukuhara et al [13] Low Unclear High* Unclear Das et al [7] Low Unclear High* Unclear Das et al [8] Low Unclear High* Unclear Lee et al [22] Unclear Unclear High* Unclear Theiler et al [18] Low Low High* Low † Tokgoz et al [14] Low Unclear High* Unclear Lee et al [16] Unclear Unclear High* Unclear Kim et al [17] Low Low High* Unclear Mitra et al [15] Low Unclear High* Unclear *Not possible to blind researchers to airway device used. †Intention to treat analysis stated.…”

Section: Oropharyngeal Leak Pressurementioning

confidence: 99%

“…The largest trial was by Lee et al [16]; they used devices of size 1.5-2.5 and found no significant difference in leak pressures between devices. Kim et al compared the i-gel with the LMA Classic in infants (children less than a year old) and found the i-gel easier to insert; otherwise the characteristics of both devices were similar [17].…”

Section: Study Selection Bias Information Bias Measurement Errors Conmentioning

confidence: 99%

A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices

Smith

Bailey

2014

Anaesthesia

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SummaryWe performed a review of published literature comparing the i‐gel™ with other supraglottic airway devices in children. Sixty‐two articles were identified following a literature search; we included data from 14 randomised controlled trials and eight observational studies that compared i‐gel sizes 1–2.5 with other commonly used, equivalently‐sized, devices. The primary outcome in most studies was oropharyngeal leak pressure. In the 14 randomised trials the i‐gel performed the same as the comparator device in five trials, significantly better in eight studies (p < 0.05) and significantly worse in one (p < 0.01). Seven studies assessed fibreoptic views of the larynx through the device; two found significantly better views through the i‐gel. Three studies reported a shorter insertion time for the i‐gel, whereas two reported a longer time. Insertion success rate, gastric tube placement and complications were similar for all the devices. Seven of the eight observational studies measured average oropharyngeal leak pressures of 20–27 cmH2O and all had first‐time insertion success rates exceeding 90%. We conclude that the i‐gel is at least equivalent to other supraglottic airway devices currently available for use in children, and may enable a higher oropharyngeal leak pressure and an improved fibreoptic view of the glottis.

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“…[14,22] Since there was no PIP data available for i-gel, sample size was calculated based on a previous study using classic laryngeal mask airway in children. [10] In their study, the mean (standard deviation, SD) PIP of the PCV and VCV mode with a classic laryngeal mask airway were 14.1 (1.6) cm H 2 O and 16.7 (2.3) cm H 2 O, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…In several studies, the incidence of gastric insufflation varied from 0% to 30% depending on the PIP and the presence of a gastric tube. [12–14] …”

Section: Introductionmentioning

confidence: 99%

A randomized comparison of volume- and pressure-controlled ventilation in children with the i-gel

Park

Kim²,

Park³

et al. 2017

Medicine

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Background:The i-gel provides good airway sealing but gastric insufflation may occur when peak inspiratory pressure (PIP) exceeds the sealing pressure of the i-gel without a gastric tube. Pressure-controlled ventilation (PCV) provides lower PIP compared with volume-controlled ventilation (VCV) and low PIP may reduce the incidence of gastric insufflation in children during positive pressure ventilation. This study was designed to evaluate PIP, oropharyngeal leak pressure, and gastric insufflation during VCV or PCV in children undergoing general anesthesia with i-gel without a gastric tube in situ.Methods:A prospective, randomized-controlled study was conducted. Thirty-four children, aged 6 to 84 months, were randomly allocated into the VCV or PCV group. Fiberoptic bronchoscopy was performed to confirm appropriate position of i-gel. Oropharyngeal leak pressure and PIP were measured after i-gel insertion, after caudal block, and after surgery. Ultrasonography was performed to detect gastric insufflation. Gastric tube was not inserted.Results:PIP in cm H2O was significantly lower in the PCV group than in the VCV group after i-gel insertion (10 [9–12] vs 12 [11–15], P = .021), after caudal block (11 [10–12] vs 13 [11–15], P = .014), and after surgery (10 [10–12] vs 13 [11–14], P = .002). There was no difference in the incidence of gastric insufflation between the 2 groups (4/17 in the VCV group and 3/17 in the PCV group) (P > .999).Conclusion:When i-gel was used without a gastric tube, gastric insufflation occurred regardless of the ventilation modes, which provided different PIP.

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A randomised comparison of the i‐gel™ and the Laryngeal Mask Airway Classic™ in infants

Cited by 30 publications

References 18 publications

Comparison of the i-gel and other supraglottic airways in adult manikin studies

Comparison of the i-gel and other supraglottic airways in adult manikin studies

A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices

A randomized comparison of volume- and pressure-controlled ventilation in children with the i-gel

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A randomised comparison of the i‐gel™ and the Laryngeal Mask Airway Classic™ in infants

Cited by 30 publications

References 18 publications

Comparison of the i-gel and other supraglottic airways in adult manikin studies

Comparison of the i-gel and other supraglottic airways in adult manikin studies

A performance comparison of the paediatric i‐gel™ with other supraglottic airway devices

A randomized comparison of volume- and pressure-controlled ventilation in children with the i-gel

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Product

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A performance comparison of the paediatric i‐gel^™ with other supraglottic airway devices