A systematic review and meta‐analysis of the i‐gel^® vs laryngeal mask airway in adults

Abstract

SummaryWe systematically reviewed 31 adult randomised clinical trials of the i-gel â vs laryngeal mask airway. The mean (95% CI) leak pressure difference and relative risk (95% CI) of insertion on the first attempt were similar: 0.40 (À1.23 to 2.02) cmH 2 O and 0.98 (0.95-1.01), respectively. The mean (95% CI) insertion time and the relative risk (95% CI) of sore throat were less with the i-gel: by 1.46 (0.33-2.60) s, p = 0.01, and 0.59 (0.38-0.90), p = 0.02, respectively. The relative risk of poor fibreoptic view through the i-gel was 0.29 (0.16-0.54), p < 0.0001. All outcomes displayed substantial heterogeneity, I 2 ≥ 75%. Subgroup analyses did not decrease heterogeneity, but suggested that insertion of the i-gel was faster than for first-generation laryngeal mask airways and that the i-gel leak pressure was higher than first generation, but lower than second-generation, laryngeal mask airways. A less frequent sore throat was the main clinical advantage of the i-gel.

Reviews, systematic reviews and Anaesthesia

“…It is easy to define the three primary causes of a drug shortage: an increase in demand; a decrease in supply; or a combination of the two. However, within these three simple categories lie concealed many complex factors that range from the unavailability of an ingredient or technical failure of a manufacturing plant to difficulties complying with increasingly intricate regulatory standards, and commercial decisions related to the market for generic drugs [2]. Even drug shortages can in themselves result in a shortage of other drugs when pharmacists and clinicians seek to acquire stocks of alternative drugs to those in impending low supply.…”

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

“…Compared to most supraglottic airways with an inflatable cuff, the i-gel (Intersurgical Ltd.; Workingham, UK) has a gel-like cuff composed of thermoplastic elastomer that does not require inflation. [6,7] If successful insertion could be established in shorter insertion time by omitting cuff inflation, the i-gel might be a more valid device in emergency settings requiring prompt airway management. Several previous studies supported this hypothesis.…”

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

“…It also includes situations such as during resuscitation or positions other than supine that make airway management more difficult [18]. Some reports suggest that SGDs require less professional skill and are suited to novice and occasional operators [3,5]. 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.…”

“…Some reports suggest that SGDs require less professional skill and are suited for novice and occasional operators [3,4]. However, insertion of SGDs by novice doctors can lead to hemorrhage and postoperative pharyngeal pain [5].…”