Successful tracheal intubation using fiberoptic bronchoscope via an I-gel™ supraglottic airway in a pediatric patient with Goldenhar syndrome -A case report-

Abstract

The I-gel™ is a single-use supraglottic airway device introduced in 2007 which features a non-inflatable cuff and allows passage of a tracheal tube owing to its large diameter and short length of the airway tube. In this case, the authors experienced a difficult airway management on a 4-year-old boy with underlying Goldenhar syndrome who underwent a tonsillectomy. Intubation using a laryngoscope was unsuccessful at the first attempt. In the following attempt, we used the I-gel™ supraglottic airway for ventilation and were able to achieve successful intubation with a cuffed tube by using fiberoptic bronchoscope through the I-gel™ supraglottic airway. The authors suggest that I-gel™ is a useful device for ventilation and it has many advantages for tracheal intubation in pediatric patients with difficult airway.

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

“…Gupta et al [35] described a case of tracheal intubation through an i-gel in a child with a burn contracture of the anterior neck whilst Kim et al [36] described the airway management of a 4-year-old child with Goldenhar syndrome scheduled for tonsillectomy; conventional laryngoscopy was unsuccessful, but a cuffed tracheal tube was successfully passed over a fibreoptic bronchoscope inserted through the i-gel. Furthermore, the i-gel is potentially useful as an airway adjunct during cardiopulmonary resuscitation [37] and the manufacturer has now developed an 'i-gel O 2 resus pack' for such purposes (this is currently only available in adult sizes).…”

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

“…This device has been used for routine elective anaesthesia and has also been shown to be effective in pre-hospital emergency airway management [1][2][3][4]. The i-gel can also be used as a conduit for fibreoptic bronchoscopy-guided tracheal intubation in patients with difficult airways [5][6][7].…”

A Case of Severe Head and Neck Post-Burn Contractures: Fiberoptic Intubation through an I-Gel Laryngeal Mask Maintaining Spontaneous Ventilation

“…There are few cases reporting the use of I-gel to facilitate fiberoptic tracheal intubation [10][11][12][13][14][15] but none of these cases was associated to the recovered burn patient and ventilation was not maintained during intubation attempts. We only found one case report describing fiberoptic intubation through I-gel LMA in a post-burn patient [16].…”