Comparison of i-gel™ and laryngeal mask airway Classic™ in terms of ease of insertion and hemodynamic response: A randomized observational study

Abstract

Context:Laryngeal mask airway (LMA) Classic™ has an inflatable cuff while i-gel™ has a noninflatable cuff made of thermoplastic elastomer.Aims:To compare ease of insertion, number, and duration of insertion attempts among the two device. Secondary objectives were to evaluate the hemodynamic response and SpO2 during device insertion and during maintenance of general anesthesia.Settings and Design:This study was conducted as randomized observational study in a teaching hospital.Subjects and Methods:One hundred American Society of Anesthesiologists I and II, patients posted for surgery under general anesthesia were divided in two groups of fifty each. LMA Classic™ and i-gel™. Ease of insertion, duration of insertion, hemodynamic data, and episodes of hypoxia during insertion, 1, 3 and 5 min for 30 min, during removal and 1 min after removal.Statistical Analysis Used:Descriptive analyses were expressed as a mean ± standard deviation. Independent t-test used for parametric data, Chi-square test for nonparametric data and hemodynamic data were analyzed using repeated measures ANOVA to find statistical difference within the groups.Results:Devices were easy to insert, the mean duration of insertion attempts was 15.92 ± 1.62 s in the i-gel™ group, while it was 26.06 ± 5.12 s in the LMA Classic™ group, was statistically significant (P = 0.0001).Conclusions:Successful and shorter duration of insertion, with less hemodynamic response makes i-gel™ a suitable alternative to LMA Classic™ during general anesthesia.

A Comparative Study of Three Supraglottic Airway Devices- Classic Lma, Proseal Lma and I-Gel, in Adult Patients Undergoing Elective Surgeries

“…There was no statistically significant change in these parameters between the groups. This was similar to the results of studies conducted by Helmy et al (12) and Shin et al (8) There are also some contrasting reports regarding hemodynamic variations, a few studies have reported higher increase in heart rate and blood pressure from baseline in Classic-LMA, (9) probably because of the inflated cuff of the Classic-LMA causing a sympathetic response. (18) End tidal CO2 was monitored with all three devices throughout the surgery.…”

“…A study by Shin et al also reported a similar lower first attempt success rate with i-gel. (8) Many studies have reported a statistically significant high first-attempt success rate with i-gel compared to ProSeal-LMA and Classic-LMA, both in airways that were adequate (9) as well as difficult airways. (10) Revi et al also reported that the ease of insertion with i-gel was more (96%) compared to that with cLMA (88%) and ProSeal LMA (80%), though it wasn't statistically significant (p=0.194).…”

Comparison of I-gel for general anesthesia in obese and nonobese patients

“…Successful insertion rates are generally higher than 80% in the first attempt and increase to >90% on subsequent attempts. [ 2 5 11 13 21 ] Theiler et al . in found in their study that overall success rate of i-gel insertion was 96%.…”

Endosonographic evaluation of the mediastinum through the i-gel O2 supraglottic airway device

“…1 Its easy insertion, the presence of a drain tube, and the possibility of intubation through the device make it a versatile tool. Several studies have been published regarding i-gel airway effectiveness 2–7 and it seems suitable also for anesthesiologists unfamiliar with SADs.…”