Comparison of two supraglottic airway devices: I-gel airway and ProSeal laryngeal mask airway following digital insertion in nonparalyzed anesthetized patients

Luthra, Ankur; Chauhan, Rajeev; Jain, Amit; Bhukal, Ishwar; Mahajan, Shalvi; Bala, Indu

doi:10.4103/aer.aer_132_19

Cited by 8 publications

(7 citation statements)

References 32 publications

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“…A total of 26 trials [ 3 , 9 – 15 , 17 – 20 , 22 – 25 , 27 – 28 , 30 – 36 , 40 ] showed that i-gel™ provided a higher rate of first-insertion success [RR = 1.03 (1.0, 1.06), I 2 = 32%, P = 0.03] than LMA ProSeal™ ( Fig 4 ). Exactly 21 trials [ 3 , 9 – 12 , 16 , 17 , 19 , 21 – 23 , 25 , 28 – 31 , 33 , 34 , 39 – 41 ] indicated that the insertion ease was substantially higher for i-gel™ than for LMA ProSeal™ [RR = 1.06 (1.01, 1.11), I 2 = 47%, P = 0.01] ( Fig 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of revealed adverse events were evaluated: blood staining on the SADs, sore throat, cough, and laryngospasm was shown in 15 [ 3 , 9 – 11 , 14 – 17 , 19 – 21 , 28 , 29 , 32 , 39 ], 10 [ 3 , 14 , 19 – 22 , 29 , 30 , 39 , 40 ], 5 [ 3 , 10 , 16 , 22 , 39 ], 3 studies [ 15 , 16 , 22 ], respectively. Blood staining on the SADs after surgery ( Fig 5 ) and sore throat ( Fig 7 ) were greatly more universally occurring with LMA ProSeal™ than with i-gel™ [RR = 0.44 (0.28, 0.69), I 2 = 25%, P = 0.0003; RR = 0.31 (0.18, 0.52), I 2 = 0%, P<0.0001, respectively].…”

Section: Resultsmentioning

confidence: 99%

“…The current meta-analysis observed a greatly higher OLP with LMA ProSeal™ than with i-gel™. The higher OLP in the LMA ProSeal™ group caused by the inflatable cuff with a ventral and dorsal cuff could have led to better seal than i-gel™ with a noninflatable cuff [ 30 ]. Growing OLP provides specific merits in fat patients, restrictive and obstructive lung diseases, lithotomy position, and pneumo-peritoneum patients [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Seven RCTs [ 9 – 15 ] observed higher OLP values in i-gel™ compared with LMA ProSeal™. However, 15 studies [ 16 – 30 ] recorded lower OLP values in i-gel™ compared with LMA ProSeal™, and 8 other research [ 3 , 31 – 37 ] found no difference. Therefore, RCTs alone cannot sufficiently offer adequate insights into the clinical applications of i-gel™ and LMA ProSeal™.…”

Section: Introductionmentioning

confidence: 99%

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Contrast of oropharyngeal leak pressure and clinical performance of I-gel™ and LMA ProSeal™ in patients: A meta-analysis

2022

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Background Conflicting outcomes have been reported for the i-gel™ and laryngeal mask airway (LMA) ProSeal™ in children and adults during general anesthesia. Randomized controlled trials (RCTs) that yielded wide contrast outcomes between i-gel™ and LMA ProSeal™ were included in this meta-analysis. Methods Two authors independently identified RCTs that compared i-gel™ with LMA ProSeal™ among patients receiving general anesthesia by performing searches in EMBASE, Cochrane, PubMed, and ScienceDirect. Discussion was adopted to resolve disagreements. Data were counted with Review Manger 5.3 and pooled by applying weighted mean difference (MD) and rlsk ratio (RR), and related 95% confidence intervals. Results A total of 33 RCTs with 2605 patients were included in the meta-analysis. I-gel™ provided a considerably lower oropharyngeal leak pressure [weighted average diversity (MD) = -1.53 (-2.89, -0.17), P = 0.03], incidence of blood staining on the supraglottic airway devices [RR = 0.44, (0.28, 0.69), P = 0.0003], sore throat [RR = 0.31 (0.18, 0.52), P<0.0001], and a short insertion time [MD = -5.61 (-7.71, -3.51), P<0.00001] than LMA ProSeal™. Compared with LMA ProSeal™, i-gel™ offered a significantly higher first-insertion success rate [RR = 1.03 (1.00, 1.06), P = 0.03] and ease of insertion [RR = 1.06 (1.01, 1.11), P = 0.03]. The gastric-tube-placement first insertion rate [RR = 1.04 (0.99, 1.10), P = 0.11], laryngospasm [RR = 0.76 (0.17, 3.31), P = 0.72], and cough [RR = 1.30 (0.49, 3.44), P = 0.60] between the two devices were similar. Conclusions Both devices could achieve a good seal to provide adequate ventilation. Compared with the used LMA ProSeal™, the i-gel™ was found to have fewer complications (blood stainning, sore throat) and offers certain advantages (short insertion time, higher first-insertion success rate and ease of insertion) in patients under general anesthesia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Contrast of oropharyngeal leak pressure and clinical performance of I-gel™ and LMA ProSeal™ in patients: A meta-analysis

2022

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“…The definition of 'procedure time' (time needed for successful insertion) varies from studies to studies and that may also explain difference in the results of various studies. 17,31 For example in one study the procedure time was defined in a different way such as from the 'moment of face mask removal up to the first capnograph upstroke' 17 while in the present study the procedure time was defined as the time from 'picking the device to the appearance of square waves of EtCO 2 '. Here, although the end point is same, the start points differ for the calculation of procedure time.…”

Section: Discussionmentioning

confidence: 97%

I-Gel and LMA classic in the hands of novice: A comparative study

Bhattacharjee¹,

Sarkar²,

Bhattacharyya³

et al. 2021

Asian J Med Sci

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Background: Supraglottic airway devices (SADs) such as LMA classic (cLMA), I-Gel, etc. are indispensable tool for the anaesthesiologists experienced in airway management. But studies evaluating the performance of these devices in the hands of unskilled personnel are scarce. Aims and Objective: To determine the procedure time and the proportion of patients having successful placement of I-gel and LMA classic by first-year Post Graduate Trainees (PGTs) of Anaesthesiology who tried insertion of those devices after a short training in mannequins without any hands-on training regarding placement of the devices in human. Materials and Methods: After getting Institute’s Ethics Committee’s approval for this interventional study, forty adult patients, posted for short surgical or gynaecological surgery, were randomly allocated in to two groups to have placement of either I-Gel (group ‘I’, n=20) or cLMA (group ‘C’, n=20) by first-year PGTs. The procedure time (Primary outcome) i.e. the time taken for successful placement of either device was determined and compared. A standard technique of anaesthesia was followed in every patient. Any adverse event such as sore throat, odynophagia, blood stain on the device, etc. was also recorded. Results: All patients were comparable with respect to demographic data and Mallampati scores. The mean procedure time (seconds) was considerably lower in I-Gel group compared with cLMA (63.3 ± 57.2 versus 163.0 ± 158.3, respectively, P value <0.001). The incidence of successful placement at first attempt was significantly higher for I-Gel group. The incidence of adverse events was comparable. Conclusion: Procedure time for I-Gel insertion is significantly shorter than with LMA Classic along with a higher success rate with first attempt for the former. I-Gel may be a better alternative as airway device for the unskilled anaesthesiologist.

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Comparing leak pressure of LMA® ProSeal™ versus i-gel® at head rotation: a randomized controlled trial

Chaki,

Koizumi,

Tachibana

et al. 2023

Can J Anesth/J Can Anesth

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Comparison of two supraglottic airway devices: I-gel airway and ProSeal laryngeal mask airway following digital insertion in nonparalyzed anesthetized patients

Cited by 8 publications

References 32 publications

Contrast of oropharyngeal leak pressure and clinical performance of I-gel™ and LMA ProSeal™ in patients: A meta-analysis

Contrast of oropharyngeal leak pressure and clinical performance of I-gel™ and LMA ProSeal™ in patients: A meta-analysis

I-Gel and LMA classic in the hands of novice: A comparative study

Comparing leak pressure of LMA® ProSeal™ versus i-gel® at head rotation: a randomized controlled trial

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