Article

Comparison of Clinical Performance of I-Gel™ with LMA—Proseal™ in Elective Surgeries

June 2009
Indian Journal of Anaesthesia 53(3):302-5

Source
PubMed

License
CC BY-NC-SA 4.0

Authors:

Maharishi Markandeshwar University, Mullana

Sixty ASA grade I & II adult patients of either sex were randomly assigned into two groups. Group I (n=30) for I-gel and Group P (n=30) for LMA – ProSeal. We assessed the airway sealing pressure, ease of insertion, success rate of insertion, ease of gastric tube placement, airway trauma by post operative blood staining of the device, tongue, lip and dental trauma, hoarseness, regurgitation / aspiration and cost effectiveness. Although the airway sealing pressure was higher with Group P (29.6 cm H2O) than with Group I (25.27 cm H20) (p < 0.05), but the airway sealing pressure of Group I was very well within the normal limit to prevent aspiration. The ease of insertion was more with Group I (29/30) than with Group P (25/30) (p < 0.05). The success rate of first attempt of insertion and ease of gastric tube placement was more with Group I (p > 0.05). Blood staining of the device & tongue, lip and dental trauma was more with Group P (p >0.05). There was no evidence of bronchospasm, laryngospasm, regurgitation, aspiration or hoarseness in either group. To conclude I-gel is a novel supraglottic device with an acceptable airway sealing pressure (25.27 cm H2O). It is easier to insert, requires less attempts of insertion, has easier gastric tube placement and is less traumatic as compared to LMA-ProSeal.

COMPARISON OF I-GEL WITH PROSEAL LMA IN ADULT PATIENTS UNDERGOING ELECTIVE SURGICAL PROCEDURES UNDER GENERAL ANAESTHESIA WITHOUT PARALYSIS

Article

Nov 2022

Comparison Of I-gel With Proseal Lma In Adult Patients Undergoing Elective Surgical Procedures Under General Anaesthesia Without Paralysis Objective: Supraglottic airway devices (SADs) have been widely used as an alternative to tracheal intubation during general anaesthesia. They are easily inserted, better tolerated, with fewer hemodynamic changes. This study compares the efcacy of two supraglottic devices (LMA Proseal and I-gel) in elective surgical procedure under general anaesthesia without paralysis. Material and Method: A prospective randomized study was conducted on 40 patients who were posted for elective short surgical procedures under general anaesthesia. They were randomly divided into two groups of 20 patients each, Group I (I-gel) and Group P (PLMA). All the patients were induced with general anaesthesia and the planned SAD was inserted with head in neutral position. Ease of insertion, number of insertion attempts, oropharyngeal seal pressure and incidence of adverse effects were assessed. Results: I-gel was signicantly easier to insert than Proseal (P < 0.05). The mean time for insertion was more with Group P (40.8±09.61 secs) than with Group I (29.63±08.13 secs). Although the airway sealing pressure was signicantly higher with Group P (26.63±1.31 cm of H2O), the airway sealing pressure of Group I (20.97 ± 2.14 cm of H2O) was within normal limit. The success rate of rst attempt insertion was more with Group I. There was no evidence of airway trauma, regurgitation, and aspiration. Sore throat was signicantly more evident in Group P. Conclusion: I-Gel is better supraglottic device with acceptable airway sealing pressure, easier to insert, less traumatic with lower incidence of sore throat. Hence, I-gel is better alternative than Proseal LMA.

IJAA VOL. 7 NO.6 November-December 2020-4

Article

Full-text available

Feb 2021

Manjula Rao

Introduction: With the availability of supraglottic devices in providing effective seal even in conditions of raised airway pressures, use of these devices in laparoscopic surgeries has become popular. Of the various supraglottic devices being used in laparoscopic surgery LMA ProSealTM and i-gelTM airway are commonly used with efficacy. The aim of this study was to compare the use of i-gelTM and LMA ProSealTM in patients undergoing Laparoscopic cholecystectomy. Methodology: This was a prospective randomized, hospital based study conducted at a tertiary care hospital. Adult inpatients of either gender posted for elective laparoscopic surgery were recruited in the study. A total of 100 patients were included out of which 50 each were randomly allocated to either i-gelTM group (Group I) or LMA ProSealTM group (Group P). After randomization, the chosen supraglottic airway device (i-gel/Proseal LMA) was inserted. Airway insertion attempts, time to successful ventilation, Gastric tube placement, Airway sealing quality, Numbers of attempts required for correct placement and complications were recorded and the data was assessed. Results: Demographic data were comparable in the two groups. The Ventilation time was found to be significantly faster with PLMA as compared to i-gel. I-gel and Proseal showed no significant differences in the airway and gastric tube insertion attempts, ventilation success rate, airway sealing pressures, SpO2, EtCO2, airway sealing quality score and intra abdominal pressures. Conclusion: Both i-gel and Proseal both provide adequate ventilation in laparoscopic cholecystectomy surgeries. Complications such as airway injury and bleeding with Proseal LMA are significantly more as compared to i-gel.

Effects of Passive Head-and-Neck Movements on the Performance of i-gel® Supraglottic Airway Device in Anesthetized Patients - A Randomized Crossover Trial

Article

Full-text available

Apr 2020

Background: Passive movements of head and neck are sometimes unavoidable during surgery under general anesthesia due to patient positioning according to the needs of the surgery or transmitted movements from surgical manipulations. Aims: This prospective crossover randomized study evaluates the effects of passive movements of the head and neck on the performance of i-gel® supraglottic airway device in spontaneously breathing patients under general anesthesia. Materials and methods: Sixty spontaneously breathing patients on pressure support ventilation with positive end-expiratory pressure (PEEP) under general anesthesia were randomized to seven sequences of passive head-and-neck movements with i-gel® in situ. After steady state of general anesthesia was achieved and maintenance with sevoflurane in N2O and O2 was reached, the passive head-and-neck movements were done. Peak airway pressure, exhaled minute volume, end-tidal carbon dioxide (ETCO2), oxygen saturation, audible leak of airway gases, and visible outward displacement of the i-gel® were recorded in the neutral position and with each passive head-and-neck movement. Paired continuous data were analyzed by Friedman rank sum test with paired Wilcoxon signed-rank test. Paired nominal data were analyzed by Cochran's Q test with pair-wise McNemar test. Results: Extension, right or left lateral flexion, and right or left rotation of the head and neck resulted in significant reduction in the exhaled minute ventilation, rise in ETCO2, and leak of airway gases compared to the neutral position (P < 0.05). Flexion movement did not cause significant changes in the exhaled minute ventilation, rise in ETCO2, and audible leak of airway gases as compared to the neutral position. Conclusions: Ventilatory performance of the i-gel® deteriorates upon extension, right or left lateral flexion, and right or left rotation of the head and neck in spontaneously breathing patients under general anesthesia on pressure support ventilation with PEEP.

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

Article

Full-text available

Dec 2022
PLOS ONE

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.

A prospective randomised comparative study of proseal LMA, I-gel and endotracheal tube in laparoscopic cholecystectomy

Article

Full-text available

Jan 2022

Introduction: The major responsibility of the anesthesiologist is to provide adequate ventilation to the patient because airway related problems are still the most common cause of anaesthesia related morbidity and mortality. The use of I-gel has been reported in laparoscopic surgeries and was found equally effective ventilatory device as PLMA. Therefore, we planned this study to compare I-gel and PLMA with ET tube in patients undergoing laparoscopic cholecystectomy. Materials and Methods: This prospective study was conducted on 90 patients of both sex, 18-60 years age, ASA grade I-II, scheduled for elective laproscopic surgery under general anaesthesia. All patients were randomised into three groups of 30 patients each; Group I (I-gel), Group P (PLMA), Group E (ET Tube). Attempts of insertion of devices, effective airway time and easiness of gastric tube; hemodynamic parameters (HR, MAP, SpO2 and EtCO2) were recorded. Results: There was significantly less 2 nd attempt required in I-gel group(10%) as compared with ET tube (36.7%) and PLMA (13.3%),(p=0.019). Laryngopharyngeal morbidity were significantly more in Group E as compared to Group P and I (p<0.05). Hemodynamic changes were significantly higher in Group E immediately after intubation which persisted for 3 minutes and immediately after extubation (p= 0.00). Conclusion: Supraglottic Airway Devices (PLMA and I-gel) were as effective as ET tube in establishing airway and the haemodynamic stability is better then ET tube in laparoscopic cholecystectomy.

A comparative study on the perfomance between I-gel® and Classic laryngeal mask airway in anaesthetized spontaneously breathing patients

Article

Sep 2021

The classic Laryngeal Mask Airway (c-LMA) is a first generation supraglottic airway device with an inflatable cuff forming a low pressure seal around the laryngeal inlet and permitting ventilation. I-gel is a supraglottic airway device made of thermoplastic elastomer which is soft gel-like and transparent. Unlike the classic LMA(c-LMA), I-gel does not have an inflatable cuff. In view of this, the present study was undertaken to compare the performance of the two supraglottic airway devices in spontaneously breathing adult patients posted for elective surgeries under general anesthesia. To compare the ease of insertion, number of insertion attempts, time for insertion, airway leak pressure, hemodynamic changes as well as perioperative complications such as cough sore throat between patients using the two devices. Sixty patients admitted in SRM medical college and research center scheduled for various elective surgical procedures under general anesthesia belonging to ASA class I and II were included in the study. They were randomly divided into two groups of 30 each using a random number generator. In group I, I-gel supraglottic airway device was used and in Group 2 classic laryngeal mask airway was used. Data was collected using a questionair containing socio-demographic details, details regarding performance of the device as well as hemodynamic changes and perioperative complications. The insertion was easy in 25 patients (83.3%) in group I, while in group II 15 patients (50%) had easy insertion. P=0.0 1781. The mean time of insertion for I-gel was (20. 17± 3 .91 seconds) which was significantly shorter compared to c-LMA (26.80 ±7.24 seconds) (P<0.001). There was no statistically significant difference between the devices with respect to number of attempts of insertion. Even though the airway leak pressure is not statically significant, the mean oropharyngeal leak pressure for I-gel was 20.40±5.68 (mm Hg), which was higher than c-LMA 18.73±5.06 (mm Hg), which is well within the normal limits to prevent aspiration. There were no statistically significant differences in hemodynamic changes. No Blood staining was seen after removal of device in I-gel group where it was observed in 2 (7%) patients in c- LMA group. Post removal cough was more in c -LMA (13 .3%) than l-gel (P= 0.04 SS*). Pharyngo-Laryngeal morbidity was more with classic LMA. Sore throat was more with the classic LMA (13 .3%) when compared to I-gel group (3%). We conclude that I-gel is a better airway when compared to c-LMA with respect to ease of insertion, shorter duration for insertion, adequate oropharyngeal seal with lesser pharyngo-laryngeal morbidity and less incidence of airway trauma.

Comparison of Proseal Laryngeal Mask Airway with the I-Gel Supraglottic Airway During the Bailey Manoeuvre in Adult Patients Undergoing Elective Surgery

Article

Full-text available

Dec 2020

Objective: Since the inception of Bailey manoeuvre, various authors have advocated for the substitution of endotracheal tube (ETT) with a supraglottic airway device (SAD) before the emergence from anaesthesia. There is scant information about the ideal supraglottic device in the literature. The present study compared the Proseal laryngeal mask airway (LMA) with the I-gel SAD during the Bailey manoeuvre. The primary objective was to compare these for ease of insertion and adequate placement of supraglottic airway, whereas the secondary objective was comparison of haemodynamics following the Bailey manoeuvre. Methods: A total of 100 patients aged 18-60 years who were scheduled for elective surgery under general anaesthesia were randomised into 2 groups: group I (Bailey manoeuvre using Proseal LMA) and group II (Bailey manoeuvre using I-gel). The Bailey manoeuvre was performed 15 min before the end of surgery using the chosen supraglottic airway as per randomisation. We measured the ease of insertion (number of attempts required for insertion) and adequate placement (Brimacombe scoring) of SADs (fibre-optic bronchoscopy). Haemodynamic parameters were recorded until 10 min after the Bailey manoeuvre. Results: The groups were comparable in terms of demographic parameters. Both the devices were comparable in terms of ease of insertion (p>0.05). Significantly higher (p<0.05) Brimacombe scores were seen with the I-gel. Significant (p<0.05) rise in systolic blood pressure, diastolic blood pressure, and mean arterial pressure was observed at the insertion of SAD, removal of ETT, and at 1 min after the Bailey manoeuvre in Proseal LMA in contrast to the I-gel. Conclusion: This study showed that the I-gel provides a better glottic visualisation and haemodynamically superior profile compared with the Proseal LMA during the Bailey manoeuvre.

Comparison of i-gel versus Proseal Laryngeal Mask Airway in Elective Procedures of Short Duration Requiring General Anaesthesia without Muscle Relaxants

Article

Mar 2020

BACKGROUND Supraglottic airway devices (SADs) have been widely used as an alternative to tracheal intubation during general anaesthesia. They are easily inserted, better tolerated, with fewer haemodynamic changes and decreased airway morbidity. The Proseal Laryngeal Mask Airway (PLMA) and the i-gel airway are the two SADs which provide higher airway leak pressures than the classic LMA. Both these devices have separate channels for gastric tube insertion and are recommended for spontaneous as well as controlled ventilation. METHODS A prospective randomized study was conducted on 76 patients who were posted for various elective short duration surgical / diagnostic procedures under general anaesthesia. They were randomly divided by closed envelope method into two groups of 38 patients each, Group I (i-gel) and Group P (PLMA). All the patients were induced with general anaesthesia and the planned supraglottic airway was inserted with head in neutral position. Ease of insertion, number of insertion attempts and incidence of adverse effects were assessed. RESULTS There was no statistically significant difference between the two groups in terms of ease of insertion, number of insertion attempts and incidence of adverse effects but there was significant statistical difference in the mean duration of insertion between the two groups. CONCLUSIONS Insertion of i-gel was significantly easier and more rapid than insertion of PLMA. Both supraglottic airway devices are ideal and can be recommended as effective alternatives to endotracheal tube for short duration surgeries under general anaesthesia without muscle relaxation.

Comparison of i-gel with LMA ProSeal for ease of insertion in adultanaesthetised paralysed patients: a prospective randomized trial

Article

Apr 2016

Background: i-gel, a recently developed non-inflatable supraglottic airway device, a suitable better alternative to cuffed inflatable suprglottic airway device like LMA ProSeal. Aim and objectives: This study aimed to compare the ease of insertion to achieve early successful airway between LMA ProSeal and i-gel. The secondary objectives were to compare hemodynamic parameters and any airway complications. Materials and methods: This prospective randomized study done in fifty (n=25, each group) ASA I and II adult patients, aged between 20 and 65 years of either sex scheduled for elective surgeries. Patients airway was secured with appropriate size either LMA ProSeal or i-gel. The time taken for successful insertion, number of attempts and ease ofgastric tube placement were recorded. Hemodynamic parameters at basal (pre operative), 1, 3 & 5 minutes after insertion were recorded. Blood stain of device and any postoperative airway complications were noted. Results: Time taken for successful insertion was significantly less in i-gel group [Group 1(LMA ProSeal) 20.56±2.00, Group 2 (i-gel) 12.08±1.53, p=0.001*]. Time taken for gastric tube placement was significantly less in i-gel group [Group 1(LMA ProSeal) 31.96±4.58, Group 2 (i-gel) 21.48±2.55, p=0.001*]. Among hemodynamic parameters, heart rate immediately after insertion of device was stable in i-gel group. The numbers of insertion attempts were also less with i-gel group. Conclusion: In our study, ease ofinsertion with less number of attempts was observed with i-gel group.So i-gel found to be the better alternative to LMA ProSeal.

Comparison of Two Supraglottic Airway Devices: I-gel Airway and ProSeal Laryngeal Mask Airway Following Digital Insertion in Nonparalyzed Anesthetized Patients

Article

Full-text available

Oct 2019

Aims: The study is aimed to compare the efficacy of I-gel and ProSeal laryngeal mask airway (PLMA) in nonparalysed anesthetized individuals following manufacturer-recommended digital insertion. Materials and methods: In this prospective randomized observational study, 40 American Society of Anesthesiologists I and II patients, aged 18-65 years scheduled for elective surgical procedures were allocated either to PLMA group (Group P, n = 20) or the I-gel group (Group I, n = 20). Following digital insertion of PLMA or I-gel, the following parameters were compared: insertion time, ease of insertion, number of attempts, failed insertion, airway reaction during insertion, oropharyngeal leak (OPL) pressure, and gastric insufflation on auscultation. Fiberoptic view of both the channels of the airway devices and ease of insertion of 12 F Ryle's tube through gastric drain channel were graded. Postoperative complications were also noted. Results: First attempt and overall insertion success were similar (PLMA, 85% and 100%; I-gel 80% and 100%, respectively). Mean (standard deviation) insertion times were similar (PLMA, 27.40 [11.51] s; I-gel 25.45 [9.03] s). Mean OPL pressure was 3.5 cm H2O higher with PLMA (P < 0.012). The passage of Ryle's tube was easier through I-gel than PLMA. Grade I glottic view (full view of the vocal cords) was visible in 17 (85%) patients who were managed with I-gel whereas only 9 (45%) patients had Grade I view in the PLMA group. Conclusion: The time required for digital insertion of PLMA and I-gel in nonparalyzed anesthetized patients is similar but PLMA forms a better oropharyngeal seal. I-gel is better positioned over the laryngeal framework and esophagus. I-gel allows easier passage of Ryle's tube through its drain channel than PLMA. The incidence and severity of postoperative sore throat and hoarseness was higher with PLMA.

COMPARISON OF CLINICAL PERFORMANCE OF I-GEL WITH CLASSICAL LARYNGEAL MASK AIRWAY IN SPONTANEOUSLY BREATHING CHILDREN UNDERGOING ELECTIVE SURGERYIN TERMS OF EASE OF INSERTION

Article

Dec 2018

BACKGROUND Supraglottic airways are designed to maintain clear airway which creates a seal around the larynx. I- Gel airway and classical laryngeal mask airway (LMA-Classic) are successfully used in children for elective airway management. Easy placement of airway devices within short time is crucial to prevent airway related complications. The aim of the study is to compare the clinical performance of novel supraglottic airway- the i-gel airway with LMA-classic in terms of ease of insertion, duration of insertion, and complication. MATERIALS AND METHODS This is a prospective randomized single blinded open study. 100 children posted for elective minor surgeries in paediatric operation theatre were enrolled in this study. Children were randomly assigned to size two i-gel group (Group I) and size two LMA group (Group L) of 50 each. All airway devices were inserted by a single junior resident of Anaesthesiology Department who had prior experience of insertion of more than 50 i-gel, and LMA-classic airway. We compared the clinical performance of i-gel airway with LMA- Classic in terms of ease of insertion, duration of insertion and complication. RESULTS Demographic data were comparable in both the groups. i-gel size two airway was easier to insert in comparison to LMA- classic. This difference was statistically significant (P = 0.02). The duration of insertion was significantly shorter in i-gel airway compared to LMA-Classic which was statistically significant (p=0.0001). The complications related to both airways were less. CONCLUSION i-gel airway is superior to LMA-classic in spontaneously breathing children undergoing elective surgery in terms of ease of insertion and duration of insertion. Both devices were safe and effective in paediatric airway management

Comparison of I-gel and Proseal LMA for airway management in pediatric patients under controlled ventilation - A prospective, randomized, single blind clinical study

Article

Sep 2018

Comparative evaluation of Ambu AuraGain™ with ProSeal™ laryngeal mask airway in patients undergoing laparoscopic cholecystectomy

Article

Full-text available

Jun 2017

Background and Aims Second generation supraglottic airways are increasingly being used in surgical patients undergoing laparoscopic surgery. Preventing aspiration at higher airway pressures may be at the expense of a higher cuff pressure which can impair mucosal perfusion. We attempted to elucidate whether Ambu AuraGain™ (AAU) would provide a higher oropharyngeal leak pressure (OLP) with a lower mucosal pressure in comparison to ProSeal™ laryngeal mask airway (PLMA). Methods This was a prospective randomised study involving sixty patients undergoing laparoscopic cholecystectomy under general anaesthesia, using either AAU (Group AAU [n = 30]) or PLMA (Group PLMA [n = 30]) for elective ventilation. Primary outcome measure was the OLP. Number of insertion attempts, ease of insertion, time required for placement and calculated pharyngeal mucosal pressure were the secondary outcome measures. Data were analysed using Student's t-test and Chi-square test. Results No significant difference in the OLP was noted in both groups. The ease of insertion and success rate at first attempt was similar between the groups. Time taken for insertion in Group AAU was longer than Group PLMA (13.57 ± 1.94 vs. 11.60 ± 2.22 s). The calculated pharyngeal mucosal pressures were lower with Group AAU than Group PLMA for all 3 sizes. The minimum cuff pressure and minimum cuff volume required to prevent leak were found similar in both groups. Conclusion AAU provides adequate sealing pressures and effective ventilation with lower calculated pharyngeal mucosal pressure, compared to PLMA.

Máscara laríngea I Gel vs ProSeal en cirugía oncológica de mama

Article

Full-text available

Apr 2014

Introduction: the supraglottic devises were initiallly used only for the respiratory via boarding anatomically diffcult. Today, anesthesiologists arrange different supraglottic for the respiratory via boarding. Objective: to characterize comparatively the performances of the larynx masks I Gel and ProSeal in the boarding of the air passage in patients subject to procedures of breast oncological surgery. Methods: a case control prospective control study blind was carried out at "Hermanos Ameijeiras" Hospital during the period from September 2009 to April 2012.200 subjects intervened were studied with procedures of ontological breast surgery under general balanced anesthesia at random with equal parts in each group. Results: both groups searched presented similar statistics as to age, body weight, physical condition and surgical time. The time of insertion of the mask in the study was significantly inferior to the control group. The average values of P1 and the volume of escape were significantly higher in the control group in each of the moments analyzed. The average values of the PAM and the FC belonging to study and control groups were revealed without significant statistical differences. The only postoperative immediate complication with significant difference outcome for the groups were light swallowing which was absent in the study group. Conclusion: the performance of the larynx mask I Gel was significantly higher than the larynx mask ProSeal.

A randomized comparative study to estimate the safety and effectiveness between laryngeal mask airway supreme and I-gel in patients undergoing elective surgeries

Article

Full-text available

Sep 2023

Background: Supreme laryngeal mask airway (SLMA) and i-gel airway devices are second generation supraglottic airway devices (SAD) and are good alternatives to intubation during elective surgeries. Aims and Objectives: This study was conducted with the objective of comparing the two SAD with respect to ease of insertion, number of attempts of insertion, insertion time, ease of gastric tube insertion, accompanying hemodynamic changes, incidence of adverse effects like regurgitation, lip and dental trauma, post-operative sore throat, dysphagia, and hoarseness. Materials and Methods: This study was conducted at M.G.M. Medical College and M.Y. hospital, Indore. Eighty patients belonging to ASA class 1 or 2, with Mallampati grading 1 or 2, between age group of 18–60 years and with BMI <30 kg/m2 were selected for the study. After induction of anesthesia, one of the SAD’s (SLMA or i-gel) was inserted following randomization, and accordingly, the patients were divided into two groups of 40 each. Insertion parameters, hemodynamic, and respiratory parameters were noted. Patients were also observed for any possible complication at 1 h and 24 h postoperatively. Results: The Two groups showed no statistically significant difference in terms of demographic characteristics, insertion parameters, hemodynamic, or respiratory parameters (P>0.05). Postoperatively, no significant complications were observed in terms of dental injury, laryngospasm. Ease of gastric tube insertion was found to be more in SLMA group than i-gel and the difference was statistically significant (P=0.0057). Incidence of sore throat after 1 h was found to be more in SLMA group than i-gel group (P=0.048). Conclusion: There was no significant difference between SLMA and i-gel in terms of insertion characteristics and hemodynamic changes. Ease of gastric tube insertion was found to be significantly more in SLMA group than i-gel. Incidence of post-operative sore throat at 1 h was more with SLMA as compared to i-gel.

Retrospective analysis of anaesthetic techniques for hysteroscopic procedures at a tertiary care centre

Article

Jul 2024

A randomized comparative study to estimate the safety and effectiveness between laryngeal mask airway supreme and I-gel in patients undergoing elective surgeries

Article

Full-text available

Sep 2023

Comparison of I-gel and laryngeal mask airway classic in terms of ease of insertion and hemodynamic response: a randomised observational study

Article

Full-text available

Jun 2023

Background: The gold standard technique for preserving a patent airway throughout anaesthesia is tracheal intubation. I-gel is a relatively new addition to the SADs. I-gel has combined the concept of the non-cuffed SADs like the SLIPA and gastric tube of the proseal LMA yet retaining the shape of laryngeal mask. Hence, we have compared ease of insertion, number and duration of insertion attempts among the two devices. Methods: This study was conducted on patients undergoing elective surgery under GA in Pacific Medical College and Hospital, Udaipur. Patients were divided into two groups: group A= LMA classic, a variant of supraglottic airway device and group B= I-gel, a variant of supraglottic airway device. The two devices were than compared with respect to success rate of insertion, time taken for insertion and ease of gastric tube placement (number of attempts) and post-operative airway morbidity. Results: Mean insertion time was 8.66±3.21 seconds in C-LMA and 6.49±1.92 seconds in I-gel (p<0.001). 97.14% was the success rate of single time attempt insertion with I-gel as compared to 88.57% in C-LMA. There was a failure rate of 11.43% in single attempt insertion with CLMA as compared to 2.86% with I-gel (p>0.05). Conclusions: We hereby concluded with our study that successful and shorter duration of insertion, with less hemodynamic response, makes I-gel™ a suitable alternative to LMA classic™ during general anesthesia.

COMPARATIVE EVALUATION OF HAEMODYNAMIC RESPONSE AT EXTUBATION BETWEEN TRACHEAL TUBE AND BAILEY'S MANOEUVRE USING i-gel® IN ADULT PATIENTS WITH CONTROLLED HYPERTENSION FOR ELECTIVE SURGERY

Article

Apr 2023

Background and Aims: Airway instrumentation leads to haemodynamic disturbances like rise in heart rate, blood pressure and risk of cardiac arrhythmias. These changes are seen more in hypertensive patients sometimes leading to serious consequences. This study evaluates and compares the changes in haemodynamic parameters (Heart Rate, Blood Pressure) in standard tracheal extubation and in Bailey's manoeuvre using i-gel ® in adult patients with controlled hypertension. Materials and methods: Sixty American Society of Anaesthesiologists (ASA) physical status II adult patients (controlled hypertensives) undergoing general anaesthesia were randomised into group E (n = 30) and group I (n = 30). In Group E endotracheal extubation was performed by employing the standard technique of extubation and in Group I Bailey's manoeuvre was employed using i-gel®. All haemodynamic data was measured on arrival in operation theatre i.e. baseline, before extubation, after extubation at 1, 3, 5, 7 and 9 min by an independent observer. Results: Both endotracheal extubation and Bailey's manoeuvre were associated with rise in Heart Rate (HR), Blood Pressure (Systolic, Diastolic and Mean Arterial Pressure) when compared with baseline values. This rise was observed higher in group E (endotracheal extubation) as compared to Group I (Bailey's manoeuvre). The percentage increase in HR, Systolic Blood Pressure, Diastolic Blood Pressure and Mean Arterial Pressure parameters was seen maximal at 1 minute after extubation than at 3 minutes, 5 minutes, 7 minutes and 9 minutes. The rise in HR at one minute of extubation was signicantly higher (p value 0.046) in E group than I group. The rise in blood pressure was also more in E group than I group but it was not statistically signicant. Conclusion: Bailey's manoeuvre using i-gel ® attenuates the increase in heart rate when compared to endotracheal extubation but it insufciently mitigates the increase in blood pressure.

A Randomised comparison and evaluation of I-gel, Supreme laryngeal mask airway and Ambu Auragain in Laparoscopic surgeries under general anaesthesia with controlled ventilation

Article

Full-text available

Apr 2021

Background: Supraglottic airway devices (SAD) are becoming increasingly popular for use in patients undergoing laparoscopic surgeries. In this prospective randomised study, we compared three supraglottic airway devices namely, I-gel, Supreme LMA and Ambu Auragain. Aims and Objectives: The study was undertaken to compare three supraglottic airway devices I-gel, Supreme LMA and Ambu Auragain in laparoscopic surgeries under general anaesthesia with controlled ventilation. Materials and Methods: This was a randomized comparative study in which 90 patients undergoing laparoscopic surgeries under general anesthesia were included. In group A Ambu AuraGain was used whereas in group I and Group S I-gel and Supreme LMA was used respectively. Primary outcome measures which were compared amongst the studied groups included time taken for insertion, ease of insertion, attempts required for insertion, ease of insertion of Ryles tube, fiberoptic bronchoscopic grading and Oropharyngeal leak pressure. Results: There was highly significant difference in the time taken for insertion of SAD in Group-A when compared to Group- I (p<0.0001) and Group-S (p<0.0001). Group-A had significantly increased grades of ease of insertion of SAD when compared to Group-I (p=0.04) and Group-S (p=0.004). 16.66% of patients in Group-A required 3 attempts for successful insertion of the SAD, while no patients in Group- I or Group A required more than two attempts for insertion(p<0.05). Conclusion: Ambu AuraGain provides better oropharyngeal seal and has higher leak pressures as compared to I-gel and Supreme LMA with similar hemodynamic stability and post-operative outcome makingit a preferable SAD over I-gel and Supreme LMA.

Comparative study of Igel with proseal LMA for ease of insertion and effect on hemodynamics in pediatric patients

Article

Full-text available

Oct 2022

Background: Supraglottic airway devices offer several advantages over endotracheal tube with regards to ease of insertion, hemodynamic stability, decreased airway morbidity, reduced requirement of drugs and smoother emergence from anesthesia. Objective was to compare two supraglottic airway devices, Igel and proseal LMA, with respect to ease of insertion, number of insertion attempts, time taken for placement of device and hemodynamic changes.Methods: This prospective, randomized observational study was conducted in a tertiary care hospital in India after obtaining approval from the ethical committee of the institute. Sample size consisted of 80 patients who were randomized into two groups with each group having 40 patients.Results: In our study it was found that Igel was easier to insert in 95% of the patients as compared to proseal laryngeal mask airway, whose insertion was found easy in 77.5% of the patients. There was higher success rate in first attempt insertion for Igel as compared to proseal laryngeal mask airway. 95% of the patients had successful device insertion in single attempt in group Igel and 77.5% of the patients had successful device insertion in single attempt in proseal laryngeal mask airway group. Time taken to insert Igel was significantly less (15.2 seconds) as compared to proseal laryngeal mask airway (26.1 seconds).Conclusions: The ease of insertion of Igel is better as compared to insertion of proseal laryngeal mask airway. The success rate in first attempt insertion for Igel is higher as compared to proseal laryngeal mask airway. Time taken to insert Igel was significantly less as compared to proseal laryngeal mask airway. However, there was no difference in hemodynamic parameters and oxygen saturation between the two groups.

Comparative study of hemodynamic responses to airway maintenance devices: Proseal LMA V/S IGEL Airway. JMSCR 2014;2(6):1320-28

Article

Full-text available

Jun 2014

Urvashi Yadav

Comparison of Laryngeal Mask Airway (Classic) and I-Gel; Ease of insertion

Article

Aug 2022

Background: At the time of induction during general anaesthesia the different complication can occur with endotracheal tube. Supraglottic devices are alternative of endotracheal tube and it prevents such complications. Aim: To compare the frequency of ease of insertion with lma and i-gel® during general anaesthesia. Method: 270 patients of asa class p1 & p2 undergoing general anaesthesia for elective surgeries were included after taking informed consent. Patients were divided into two groups a (lma classic) & b (i-gel) by using random number table. Each group comprised of 135 patients. In both groups dose of propofol was 2.5mg /kg body weight was given intravenously within 30 sec along with nalbuphine 0.1 mg /kg body weight and midazolam 0.05mg / kg body weight. The study design was quasi experimental and sampling technique was purposive non probability convenience sampling. Chi square test was used and collected data was analysed with spss version 20. Result: The ease of insertion in the lma classic group was 82% while the ease of insertion in i-gel® was 84 %. Statistically there was no significant difference of ease of insertion between two groups (p value = 0.41). Conclusion: Both devices have same level of ease of insertion. Keywords: Lma (laryngeal mask airway classic), i-gel®, general anaesthesia, ease of insertion

Comparison of Perioperative Results of the Use of a Double-Lumen Tube and Laryngeal Mask Airway in Video-assisted Thoracoscopic Wedge Resection: A Retrospective Clinical Study

Article

Full-text available

Jun 2022

Comparison of Different Methods in Determining the Laryngeal Mask Airway (LMA) Size in Adult Patients

Preprint

Full-text available

May 2022

Purpose In this study, we aimed to compare the effects of different LMA size selection methods on successful LMA application, perioperative ventilation parameters and postoperative airway complications in determining the appropriate size of LMA used for elective surgery in adult patients in our operating room. Methods All data obtained from records of ASA group I-II patients between ages 18 and 70, who were anesthetized by using LMA and had elective surgery. Cases were classified according to methods used for deciding appropriate LMA size, and retrospectively successful LMA application, perioperative ventilation parameters and postoperative complications were recorded. Results A total of 190 patients were included in our study grouped in 5 different ways. For the 51 cases, the LMA size was chosen according to the body weight of the patients in LMA size selection guided weight according to the body weight of the manufacturer. For the thirty-three cases, the size of the LMA, approximately equal to the width of the external auditory canal auricula, was used. The size of the LMA selected for thirty-eight cases was the LMA dimensions corresponding to the language width of the cases. In thirty-six cases, the size of the LMA that corresponds to the width of the fingers, while the thumb, and the small finger were opened to the outside, and the second, third and fourth fingers were adjacent, were preferred. In thirty-two cases, it was found that the appropriate LMA was chosen to correspond to this distance by looking at the thyromental distances of the cases. The best score in terms of LMA insertion score was found out to be in Group Ear. The best group in terms of the number of attempts to place the LMA in the cases was found out as Group Ear. Group Ear was the best group for the complications of sore throat in terms of postoperative complications. Conclusion The results of our study showed that the ear size measurement method was one of the effective methods to decide the appropriate LMA size. Therefore, it can be said that the ear size can be used as a guide for the selection of the appropriate LMA size. This method may be an addition to the methods currently in use and can save users from remembering formulas and tables based on body weight / gender.

Success Rate of Insertion and Postoperative Sore Throat: I-Gel Versus Laryngeal Mask Airway Classic

Article

Full-text available

Jul 2021

Introduction: Supraglottic devices are a useful advent in airway management filling a gap between the facemask and tracheal tube in terms of both anatomical position and degree of invasiveness. Laryngeal mask airway classic (LMA-C) being first of its kind and I-gel is second generation non-inflatable supraglottic device. The objective of our study was to compare the two supraglottic devices, Laryngeal mask airway classic (LMA-C) and I-gel for a success rate of insertion and postoperative sore throat. Materials and Methods: A total of 80 patients scheduled for elective surgical procedures were studied in a prospective, randomly assigned, comparative and interventional manner. Patients were randomly allocated into two groups with forty patients in each group. I-gel and LMA-C were used in Groups 1 and 2 respectively. After achieving adequate depth of anesthesia the supraglottic device of appropriate size was inserted. The success rate of insertion of the device was represented by the number of insertion attempts. In the postoperative ward within 24 hours after surgery patient was asked whether a sore throat was present. Results: There was a statistically significant difference between the two supraglottic devices in terms of successful attempts of insertion (p-value 0.02).In group 1(I-gel)34 out of 40 patients had first attempt insertion success,6 patients in the second attempt, and no patient had third insertion attempt. In group 2 (LMA-C) first-time insertion success was in 14 patients, 23 patients in the second attempt, and 3 patients in the third attempt. The incidence of postoperative sore throat was higher in the LMA-C group than the I-gel group(17.5% vs 5% respectively) with a p-value of 0.154. Conclusion: Compared to the laryngeal mask airway classic, I-gel was inserted with less number of attempts and had a lower incidence of postoperative sore throat.

Comparison of Safety and Efficacy of Endotracheal Tube, Laryngeal Mask Airway Supreme and I Gel in Laparoscopic Surgeries

Article

Mar 2021

BACKGROUND Present study was undertaken to assess the feasibility of laryngeal mask airway (LMA) supreme and I gel, the second generation supraglottic airway devices in laparoscopic surgeries. METHODS 120 patients with American Society of Anaesthesiologists (ASA) I and II (20 - 50 years) of either sex who underwent laparoscopic surgery under general anaesthesia were randomly divided into three groups. Airway was secured with endotracheal tube (ETT) in group E (N = 40), with LMA supreme in Group S (N = 40) and with I-gel in group I (N = 40). Insertion characteristics of airway device, ease of gastric tube insertion, haemodynamic response and perioperative laryngopharyngeal morbidities were assessed. RESULTS I-gel was easier to insert with higher first attempt success rate (95 %) than LMA Supreme (85 %) and ETT (90 %) but it was statistically insignificant. Heart rate (HR) and mean arterial pressure (MAP) was significantly higher in ETT group at the time of intubation, continued till 5 minutes and also at the time of extubation but statistically significant increase in HR and MAP were noted in group S and I only at the time of device insertion. Gastric tube was easier to insert in group S with shortest insertion time which was statistically significant. Incidence of coughing, dysphonia, dysphagia and sore throat was significantly more in group E. CONCLUSIONS I-gel and LMA Supreme can be used as an alternative to ETT for airway management in adult patients undergoing elective laparoscopic surgeries.

UTILITY OF SUPRA-GLOTTIC AIRWAY DEVICE IN CRITICAL CARE UNIT.

Thesis

Full-text available

Feb 2021

Study was designed to evaluate the feasibility of I-Gel for short term mechanical ventilation in patients admitted in ICU and to compare with the endotracheal tube in terms of haemodynamic changes, and lung mechanics. Methods:Total 40 patients with the age of 16 -65 years of either sex who required short term of mechanical ventilation up to 3 hours, were randomized allocated into two groups i.e. Group A and Group B. In group A, the appropriate size of I-gel was used with standard technique. In group B, after direct laryngoscopy an appropriate size endotracheal tube was introduced in the trachea. Blood pressure, Heart rate, Airway pressure, Static compliance and (PaO2/FiO2) ratio and complications were recorded. Results: Mean insertion time for i-gel and ETT was [12.53±3.2sec] and [16.60±2.4sec] respectively. We did not found any statistically significant changes in heart rate and systolic BP while diastolic BP was noticed to be increased with time in group A. Mean P/F ratio in both groups compared to baseline, increase with time which was higher in Group B as compared to Group A. The mean Ppeak in both groups, increase with time and was slightly higher in Group B as compared to Group A. Static Compliance was lower in Group B than Group A at all periods. Mean duration of ventilation and ICU stay were comparable and not statistically significant.

Comparison of hemodynamic and Ventilator parameters with i-gel vs endotracheal tube in patients for laparoscopic cholecystectomy

Article

Feb 2021

Ankita Chandel

Comparative Evaluation of I Gel and Cuffed ET Tube for Anesthesia in Abdominal Surgery

Article

Sep 2019

A Comparative Study Regarding the Haemodynamic Stress Response and Efficacy of Endotracheal Intubation and i-gel Insertion During Infraumbilical Surgery

Article

Apr 2020

Citation: Sunil Rajan, et al. Postoperative Sore Throat, Hoarseness and Cough Following Use of Two Different Supraglottic Airway Devices: A Comparison of Baska Mask versus I- Postoperative Sore Throat, Hoarseness and Cough Following Use of Two Different Supraglottic Airway Devices: A Comparison of Baska Mask versus I-Gel

Article

Full-text available

Aug 2019

Background: Use of supraglottic devices reduces incidence and severity of postoperative sore throat (POST), cough (POC) and hoarseness of voice (POHV) as compared to endotracheal intubation. We aimed to compare incidence and severity of POST, POC and POHV following use of Baska mask versus I-Gel.

Comparing Supraglottic Airway Devices for Airway Manage-ment During Surgery in Children: A Review of Literature

Article

Full-text available

Apr 2019

Context: Supraglottic Airway Devices (SADs) are applied in airway management of pediatric emergency conditions. Objective: This review study aimed to examine the literature regarding pediatric supraglottic airway devices, to introduce the optimal devices in terms of Oropharyngeal Leak Pressure (OLP), risk of insertion failure on the first attempt and risk for blood staining of the device. Data Sources: An electronic search was conducted on MEDLINE, EMBASE, CINAHL and PubMed databases. We also searched the Cochrane database (CENTRAL) and Web of Science up to July 1, 2017. Study Selection: Of 112 potential studies, the full texts of 53 articles were available, in which 15 were duplicated and omitted, accordingly. Papers which did not directly discuss SADs were also excluded. In total, 30 papers were identified related to the children supraglottic devices. Data Extraction: The current review was conducted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Results: The LMA ProSeal may be the best supraglottic airway device for children due to its high oropharyngeal leakage pressure and low risk of insertion failure. It seems that i-gel is a very functional tool as well. Conclusions: Further research is recommended to investigate the most appropriate supraglottic airway in diverse clinical situations and various conditions among children.

Comparison of clinical performance of laryngeal mask airway supremeTM and I-gelTM in patients undergoing elective non-laparoscopic surgeries

Article

Sep 2018

COMPARISON OF SUPRAGLOTTIC AIRWAY DEVICE I-GEL WITH CLASSIC LARYNGEAL MASK AIRWAY AND PROSEAL LARYNGEAL MASK AIRWAY FOR SHORT SURGICAL PROCEDURES

Article

Apr 2018

Comparision of Ambu AuraGain™ and LMA® ProSeal in children under controlled ventilation

Article

Full-text available

Jun 2018

Background and aims: The LMA ProSeal® is considered a prototype among the second-generation supraglottic airway devices (SAD). The Ambu AuraGain™ is a relatively new, single use, second-generation SAD with a preformed shape. We conducted this study with the aim of comparing the difference in clinical performance between Ambu AuraGain™ and LMA ProSeal® in children receiving controlled ventilation. Methods: Ninety-four children, aged between 6 months to 12 years, weighing 5 to 30 kg, belonging to American Society of Anesthesiologists Physical Status I and II, undergoing elective surgical procedures, were randomized into two groups. The primary end-point was oropharyngeal seal pressure, and the secondary parameters were the number of attempts, time of insertion, ease of placement of the device and gastric tube, and fiberoptic visualization of the laryngeal aperture. Results: The mean oropharyngeal seal pressure with Ambu AuraGain™ was significantly higher than LMA ProSeal® (23.3 ± 4.6 cmH2O vs 20.6 ± 4.8 cmH2O, P = 0.007, respectively). The ease and success rate for device placement, fiberoptic visualization of the larynx, and complications were comparable. However, the time for insertion in Ambu AuraGain™ group was shorter when compared to LMA ProSeal® group, median (IQR [range]); 12 (10-15) s vs 20 (18-23) s (P < 0.001), respectively. The gastric drain was significantly easier to insert in Ambu AuraGain™ compared to LMA® ProSeal (P = 0.01). Conclusion: Our study suggests that Ambu AuraGain™ could be a useful disposable alternative to LMA ProSeal® for securing airway in children.

A Comparative Study of Pro Seal Laryngeal Mask Airway, i-gel and Combitube under General Anaesthesia for Elective Surgical Patients Requiring Controlled Ventilation

Article

Full-text available

Feb 2018

Ravi Anand

Supraglottic Devices in Laparoscopic Surgery - A Review of Literature

Article

Full-text available

Sep 2016

Shalini Subramanian

A randomised controlled trial comparing ProSeal laryngeal mask airway, i-gel and Laryngeal Tube Suction-D under general anaesthesia for elective surgical patients requiring controlled ventilation

Article

Full-text available

Dec 2017

Background and Aims The ProSeal™ laryngeal mask airway (PLMA), i-gel™ and Laryngeal Tube Suction-D (LTS-D™) have previously been evaluated alone or in pair-wise comparisons but differing study designs make it difficult to compare the results. The aim of this study was to compare the clinical performance of these three devices in terms of efficacy and safety in patients receiving mechanical ventilation during elective surgical procedures. Methods This prospective, randomised, double-blind study was conducted on 150 American Society of Anesthesiologists physical status I–II patients, randomly allocated into 3 groups, undergoing elective surgical procedures under general anaesthesia. PLMA, i-gel™ or LTS-D™ appropriate for weight or/and height was inserted. Primary outcome measured was airway sealing pressure. Insertion time, ease of insertion, number of attempts, overall success rate and the incidence of airway trauma and complications were also recorded. Intergroup differences were compared using one-way analysis of variance with post hoc correction for continuous data and Chi-square test for categorical variables. Results Overall success rate was comparable between the three devices (i-gel™ 100%, LTS-D™ 94%, PLMA 96%). Airway sealing pressure was lower with i-gel™ (23.38 ± 2.06 cm H2O) compared to LTS-D™ (26.06 ± 2.11 cm H2O) and PLMA (28.5 ± 2.8 cm H2O; P < 0.0005). The mean insertion time was significantly more in PLMA (38.77 ± 3.2 s) compared to i-gel™ (27.9 ± 2.53 s) and LTS-D™ (21.66 ± 2.31 s; P < 0.0005). Conclusion Airway sealing pressure and insertion time were significantly higher in PLMA compared to i-gel™ and LTS-D™.

A COMPARATIVE STUDY BETWEEN I-GEL VERSUS CUFFED ENDOTRACHEAL TUBE IN LAPAROSCOPIC SURGERIES IN ADULT PATIENTS

Article

May 2014

COMPARISON OF I-GEL AND PROSEAL LARYNGEAL MASK AIRWAY FOR AIRWAY MANAGEMENT IN ADULT PATIENTS UNDERGOING ELECTIVE SURGERIES IN GENERAL ANAESTHESIA

Article

Jun 2017

Comparison of I-Gel versus Blockbuster Laryngel Mask Airway in Patients undergoing Day Care Surgery

Article

Aug 2024

ĐÁNH GIÁ HIỆU QUẢ CỦA MẶT NẠ THANH QUẢN I-GEL TRONG THỰC HÀNH GÂY MÊ TỔNG QUÁT

Article

Sep 2023

Đỗ Việt Nam

Mục tiêu: Đánh giá thuận lợi và các biến đổi huyết động trên các bệnh nhân gây mê tổng quát khi sử dụng mặt nạ thanh quản I-gel và mặt nạ thanh quản cổ điển. Đối tượng và phương pháp: Nghiên cứu thử nghiệm lâm sàng trên hai nhóm bệnh nhân có chỉ định và được gây mê tổng quát thực hiện phẫu thuật theo chương trình (nhóm 1: gồm 50 bệnh nhân đặt mặt nạ thanh quản cổ điển; nhóm 2 gồm 50 bệnh nhân đặt mặt nạ thanh quản I-gel), tại Bệnh viện Quân y 7B, từ tháng 3/2022 đến tháng 7/2022. Kết quả: Không có sự khác biệt về tuổi, giới tính, BMI, tình trạng sức khỏe theo phân độ Mallampatti, ASA giữa hai nhóm bệnh nhân nghiên cứu. Tỉ lệ thành công trong lần đặt đầu tiên với mặt nạ thanh quản I-gel (86,0%) cao hơn so với mặt nạ thanh quản cổ điển (84,0%), nhưng khác biệt không có ý nghĩa thống kê. Thời gian trung bình đặt mặt nạ thanh quản cổ điển (36,06 ± 5,12 giây) dài hơn so với đặt mặt nạ thanh quản I-gel (25,92 ± 3,62 giây), khác biệt với p = 0,0001. Nhóm đặt mặt nạ thanh quản I-gel có sự biến đổi nhịp tim, huyết áp tâm thu, huyết áp tâm trương tại các thời điểm khảo sát thấp hơn so với nhóm đặt mặt nạ thanh quản cổ điển, khác biệt có ý nghĩa thống kê (với p = 0,0001). Kết luận: Mặt nạ thanh quản I-gel có thể thay thế cho mặt nạ thanh quản cổ điển trong gây mê tổng quát cho phẫu thuật.

COMPARISON BETWEEN TWO SUPRA GLOTTI CAIR WAY DEVICE SI-GEL AND LMA-SUPREME IN SHORT LAPROSCOPIC SURGERIES UNDER GENERAL ANAESTHESIA

Article

Full-text available

Jan 2022

Aims And Objectives: In short laproscopic surgeries , 2nd generation supraglottic airway devices are recommended as good and safe alternative to intubation .We compared I gel and LMA supreme in short laproscopic surgeries under general anaesthesia with respect to ease and time for insertion ,the number of attempts, seal pressure under general anaesthesia Secondary- To compare hemodynamic changes and post of complications like sore throat ,blood staining of device ,bronchospasm , laryngospasm . Materials And Method Study Design: Randomized , prospective, single blind, comparative interventional study METHODS- Eighty patients between 18-60 years of age of either sex, BMI < 30, ASA- I and ASA- II undergoing short laproscopic surgeries of less than one hour duration under general anaesthesia were included in this study after approval of institutional ethical committee. They were randomly allocated to I gel [ n=30] and supreme [n= 30] group .They were compared with respect to primary and secondary objectives ANALYSIS PLAN- Collected data were analysed using statistical package IBM SPSS version 16. Result: Both groups were comparable with respect to demographic data , number of attempts, incidence of complications and hemodynamic response. Insertion of LMA supreme was significantly easy than I gel[ p =0.038] Conclusion: LMA-Supreme is safe and effective device which is easier to insert than I-GEL and causes less airway trauma.

To compare the frequency of postoperative sore throat with I-gel versus laryngeal mask airway in patients

Article

Dec 2021

Background: In case of general anesthesia, airway maintenance along with least complications is the most important goal of team of anesthesiologists. In case of clinical practice, the laryngeal mask airway (LMA) devices have superiority in managing supraglottic airway. Recently i-gel airway has been introduced as supraglottic airway equipment (disposable). Aim: To make comparison between laryngeal mask and I-gel with respect to postoperative complication of sore throat in case of patients who were given general anesthesia. Study design: Randomized trial Setting: Anesthesia Department Study duration: 6 after synopsis approval in total 6months of duration Methods: Candidates were divided randomly divided into two groups. In case of members of group A, patients were given i-gel where as members of group B, disposable LMA was given. General anesthesia was administered according to the standardized protocols. A day after operation, candidates were check post operatively for 24 hours, for sore throat and information was documented on Performa. Results: The candidates mean age was 44.23±15.11years in case of i-gel group members whereas 46.10±15.56 years in case of LMA group. In case of i-gel group, there were about twenty five males members and thirty five were females members . In case of LMA group members, there were about twenty six males and thirty four female members . In present case research, sore throat postoperatively was seen in case of 17(14.2%) cases, i.e. 4 (6.7%) in i-gel group while 13(21.7%) in case of LMA group. The significant difference was witnessed between members of both groups (p<0.05). Conclusion: Thus i-gel is better than LMA for general anesthesia as it has fewer chances of side effects like postoperative sore throat. Keywords: Postoperative sore throat, I-gel, laryngeal mask airway, general anesthesia

Videolaryngoscopic evaluation of hypopharyngeal lesions caused by PLMA and I-gel: A Randomised Controlled Clinical Trial

Article

Apr 2021

Objective The ProSeal laryngeal mask airway (PLMA) and I-gel, both second-generation supraglottic airway devices have been compared in previous studies but with inconsistent results regarding their safety and efficacy. Their influence on the hypopharyngeal mucosa have not been evaluated before under videolaryngoscopy. Methods One hundred ASA I-II patients, aged 18-70 years who underwent elective surgery were randomly allocated for airway management with the I-gel or ProSeal laryngeal mask airway. Mucosal oedema, mucosal colour change and nodularity were evaluated with videolaryngoscopy. Insertion times, oropharyngeal leak pressure and complications were assessed. Results For the ProSeal laryngeal mask airway, the mean insertion time (28 ± 15 vs. 18 ± 9.91, P<0.001) and oropharyngeal leak pressure at the time of insertion (27 ± 7 vs. 23 ± 5, P=0.01) were significantly higher than the I-gel. With the ProSeal laryngeal mask airway, the incidences of dysphagia were higher at 1 and 12 hours postoperatively (30% vs.12%, P=0.024) and (16% vs. 4%, %, P=0.046). A significant relationship was found between hypopharyngeal hyperemia and dysphagia (P=0.001). Conclusion The use of the I-gel resulted in fewer complications than the ProSeal laryngeal mask airway and seems to be advantageous over the ProSeal laryngeal mask airway in adults under general anaesthesia.

Comparative Study of I-GEL and Endotracheal Tube in Elective Laparoscopic Gynecological Surgeries under General Anesthesia

Article

May 2019

Introduction: Laparoscopic procedures have become the need of the hour. Pneumoperitoneum and positional variations in laparoscopy causes alterations in hemodynamic and ventilatory parameters, which results in making the task of anesthesiologist more challenging. Endotracheal tube (ETT) has been the gold standard for induction of general anesthesia but the newer supraglottic airway devices (SADs) (LMA, I-Gel) has increased the armamentarium of anesthesiologists. Our main aim was to compare I-Gel and endotracheal Tube and to consider I-Gel as safe and effective alternative to endotracheal tube for general anesthesia in elective laparoscopic surgeries. Materials and Methods: It was a comparative prospective randomized study conducted on 128 patients (ASA I/II) after consent from institutional ethical committee. Patients were divided in two groups 64 each. Group A induced with I-Gel without muscle relaxant and Group B with endotracheal tube after laryngoscopy and muscle relaxant. Alterations in pulse rate, blood pressure were noted down and ease and time of insertion were compared. Results: The ease of insertion and the attempts of insertion were comparable but the time of insertion was less with I-Gel with results being statistically significant. The rise in hemodynamic parameters from baseline was more in endotracheal tube intubated patients and so was the incidence of postoperative complications. Conclusion: We concluded that I-Gel requires less time for insertion with minimal hemodynamic changes in comparison to endotracheal tube. I-Gel also provided adequate positive-pressure ventilation, comparable with endotracheal tube. Thus I-Gel can be considered safe and suitable alternative to endotracheal tube for laparoscopic surgeries.

ENDOBRONCHIAL ULTRASOUND-GUIDED LUNG BIOPSIES UNDER PROCEDURAL SEDATION- I-GEL OR PLMA- A COMPARATIVE STUDY

Article

Jul 2018

COMPARISON BETWEEN INDUCTION WITH ETOMIDATE, PROPOFOL AND THIOPENTONE TO FACILITATE i-gel (SUPRAGLOTTIC AIRWAY DEVICE) INSERTION IN ELECTIVE SHORT SURGICAL PROCEDURES

Article

Full-text available

Apr 2018

BACKGROUND An ideal induction agent provides rapid and smooth onset of action, intraoperative amnesia and analgesia and optimal surgical conditions and adequate muscle relaxation with rapid recovery. Supraglottic airway devices are the most preferred technique of airway management for day care surgery. Etomidate, Propofol and Thiopentone with fentanyl provides optimal condition for supraglottic airway device insertion. The aim of this study was to compare the success rate of introducing i-gel (Supraglottic Airway Device) with induction agent etomidate, propofol and thiopentone in patients undergoing elective short surgical procedures. MATERIALS AND METHODS In a prospective, randomized, double blind study 90 patients scheduled for elective surgeries were assigned to one of three groups (n = 30). RESULTS The age and body weight of patients in three group were statistically analysed by analysis of variance test (Fisher test) found comparable between groups. The overall assessment of i-gel insertion was excellent in 50% Group-I, 67% in Group-II and 48% in Group-III (p< 0.05), which was statistically significant. Incidence of adverse response to airway manipulation in etomidate and thiopentone group was significantly higher than that of propofol group. CONCLUSION Propofol provides best conditions for i-gel insertion compared to etomidate and thiopentone. Propofol was associated with highest incidence hypotension and apnoea during induction, etomidate had least. Recovery in propofol and etomidate group was comparable whereas in thiopentone group recovery was significantly prolonged.

Application of Discharge Criteria for Home Readiness Using Bispectral and Supraglottic Airway Devices in Day-care Surgery without Using Muscle Relaxants

Article

Full-text available

Oct 2017

Introduction The availability of rapid and short-acting intravenous and volatile anesthetics has facilitated early recovery that is why nowadays ambulatory surgery is becoming more common. If the criteria used to discharge patients from the Postanesthesia Care Unit (PACU) are met in the operating room (OR), it would be appropriate to consider bypassing the PACU and transferring the patient directly to the step-down unit. This process is known as “fast-tracking” after ambulatory surgery. Aims To compare hemodynamic characteristics and recovery profile as per fast-track criteria (FTC) of recovery and postanesthesia discharge scoring system (PADSS) between sevoflurane and desflurane. Materials and Methods One hundred American Society of Anesthesiologists Class I–II patients aged 20–50 years were randomly divided into two groups. Following anesthesia induction with injection propofol and injection dexmedetomidine airway was secured with i-gel, Group D (n = 50) received desflurane + dexmedetomidine + O2 + N2O and Group S (n = 50) received sevoflurane in place of desflurane. Emergence time was noted and FTC was evaluated in the OR, Score >12 is considered as shifting criteria for ambulatory surgery unit (ASU). PADSS was noted in ASU at an interval of 15 min for 3 h and Score >9 is considered as ready to discharge home. Results Response to pain, verbal commands, and spontaneous eye opening in Group D was shorter than that in Group S (P = 0.001). Mean time to achieve FTC score >12 was 15 min in both the groups. Eighty-six percent of patients were ready to go home between 60 and 90 min using PADSS. Conclusion We concluded that early recovery is faster for desflurane, and there is no difference in ready to go home time between desflurane and sevoflurane.

The LMA ‘ProSeal’ - A laryngeal mask with an oesophageal vent

Article

Full-text available

Jun 2000

We describe a new laryngeal mask airway (LMA) that incorporates a second tube placed lateral to the airway tube and ending at the tip of the mask. The second tube is intended to separate the alimentary and respiratory tracts. It should permit access to or escape of fluids from the stomach and reduce the risks of gastric insufflation and pulmonary aspiration. It can also determine the correct positioning of the mask. A second posterior cuff is fitted to improve the seal. A preliminary crossover comparison with the standard mask in 30 adult female patients showed no differences in insertion, trauma or quality of airway. At 60 cm H2O intracuff pressure, the new LMA gave twice the seal pressure of the standard device (P<0.0001) and permitted blind insertion of a gastric tube in all cases. It is concluded that the new device merits further study.

Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients

Article

Feb 1999

We have compared four tests for assessing airway sealing pressure with the laryngeal mask airway (LMA) to test the hypothesis that airway sealing pressure and inter-observer reliability differ between tests. We studied 80 paralysed, anaesthetized adult patients. Four different airway sealing pressure tests were performed in random order on each patient by two observers blinded to each other's measurements: test 1 involved detection of an audible noise; test 2 was detection of end-tidal carbon dioxide in the oral cavity; test 3 was observation of the aneroid manometer dial as the pressure increased to note the airway pressure at which the dial reached stability; and test 4 was detection of an audible noise by neck auscultation. Mean airway sealing pressure ranged from 19.5 to 21.3 cm H2O and intra-class correlation coefficient was 0.95-0.99. Inter-observer reliability of all tests was classed as excellent. The manometric stability test had a higher mean airway sealing pressure (P < 0.0001) and better inter-observer reliability (P < 0.0001) compared with the three other tests. We conclude that for clinical purposes all four tests are excellent, but that the manometric stability test may be more appropriate for researchers comparing airway sealing pressures.

The ProSeal laryngeal mask airway: A randomized, crossover study with the standard laryngeal mask airway in paralyzed, anesthetized patients

Article

Jul 2000

The ProSeal laryngeal mask airway (PLMA) is a new laryngeal mask device with a modified cuff to improve seal and a drainage tube to provide a channel for regurgitated fluid and gastric tube placement. In the present randomized, crossover study, the authors tested the hypothesis that ease of insertion, airway sealing pressure, and fiberoptic position differ between the PLMA and the standard laryngeal mask airway (LMA). For the PLMA, we also assess ease of gastric tube placement and the efficacy of an introducer tool. Sixty paralyzed, anesthetized adult patients were studied. Both devices (only size 4) were inserted into each patient in random order. Airway sealing pressure and fiberoptic position were determined during cuff inflation from 0 to 40 ml in 10-ml increments. Gastric tube insertion was attempted with the PLMA if there was no gas leak from the drainage tube. In 60 additional patients, ease of insertion for the PLMA was compared with and without an introducer. First-time success rates were higher (60 of 60 vs. 52 of 60; P = 0.003) and the effective airway time shorter (9 +/- 3 s vs20 +/- 18 s; P < 0.0001) for the LMA. There were no failed uses of either device within three attempts. Airway sealing pressure was 8-11 cm H2O higher for the PLMA at all cuff volumes (P < 0.00001) and was higher in females for both devices. Fiberoptic position was better with the LMA at all cuff volumes (P < 0.00001), but vocal cord visibility was similar (LMA, 59 of 60; PLMA, 56 of 60). For the PLMA, gastric tube placement was successful in 58 of 58 patients and took 9 +/- 5 s. First-time success rates were higher (59 of 60 vs53/60; P = 0.03) and the effective airway time shorter (15 +/- 13 s vs 23 +/- 18 s; P = 0.008) with the introducer. The PLMA is capable of achieving a more effective seal than the LMA and facilitates gastric tube placement, but it is more difficult to insert unless an introducer tool is used. When correctly positioned, the PLMA isolates the glottis from the upper esophagus with possible implications for airway protection.

A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMATM) in paediatric patients

Article

Jun 2001

This study compares four tests for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA). We tested the hypothesis that the oropharyngeal leak pressure and interobserver reliability differs between tests. Eighty paralysed anaesthetized paediatric patients (weight 10-30 kg) were studied with the intracuff pressure set at 60 cmH2O. Four different oropharyngeal leak pressure tests were performed in random order on each patient by two observers blinded to each other's measurements. Test 1 involved detection of an audible noise. Test 2 involved detection of endtidal CO2 in the oral cavity. Test 3 involved observation of the aneroid manometer dial as the pressure increased and noting the airway pressure at which the dial reaches stability. Test 4 involved detection of an audible noise by neck stethoscopy. The mean oropharyngeal leak pressure was 12.5 cmH2O and was similar between tests. The intraclass correlation coefficient was 0.99 for all tests and was classed as excellent. We conclude that all four tests provide accurate and reliable information about oropharyngeal leak pressure in children.

A Multicenter Study Comparing the ProSealTM and ClassicTM Laryngeal Mask Airway in Anesthetized, Nonparalyzed Patients

Article

Feb 2002

The laryngeal mask airway ProSeal (PLMA), a new laryngeal mask device, was compared with the laryngeal mask airway Classic (LMA) with respect to: (1) insertion success rates and times; (2) efficacy of seal; (3) fiberoptically determined anatomic position; (4) orogastric tube insertion success rates and times; (5) total intraoperative complications; and (6) postoperative sore throat in nonparalyzed adult patients undergoing general anesthesia, hypothesizing that these would be different. Three hundred eighty-four nonparalyzed anesthetized adult patients (American Society of Anesthesiologists physical status I-II) were randomly allocated to the PLMA or LMA for airway management. In addition, 50% of patients were randomized for orogastric tube placement. Unblinded observers collected intraoperative data, and blinded observers collected postoperative data. First-attempt insertion success rates (91 vs. 82%, P = 0.015) were higher for the LMA, but after three attempts success rates were similar (LMA, 100%; PLMA, 98%). Less time was required to achieve an effective airway with the LMA (31 +/- 30 vs. 41 +/- 49 s; P = 0.02). The PLMA formed a more effective seal (27 +/- 7 vs. 22 +/- 6 cm H2O; P < 0.0001). Fiberoptically determined anatomic position was better with the LMA (P < 0.0001). Orogastric tube insertion was more successful after two attempts (88 vs. 55%; P < 0.0001) and quicker (22 +/- 18 vs. 38 +/- 56 s) with the PLMA. During maintenance, the PLMA failed twice (leak, stridor) and the LMA failed once (laryngospasm). Total intraoperative complications were similar for both groups. The incidence of postoperative sore throat was similar. In anesthetized, nonparalyzed patients, the LMA is easier and quicker to insert, but the PLMA forms a better seal and facilitates easier and quicker orogastric tube placement. The incidence of total intraoperative complications and postoperative sore throat are similar.

Comparison of the LMA – ProSeal and LMA classic in children

Article

Nov 2004

The LMA-ProSeal is a new laryngeal mask airway with a rear cuff and drainage tube that allows a higher seal pressure than the LMA-Classic for the same intra-cuff pressure, and it permits drainage of gastric secretions and access to the alimentary tract. The LMA-ProSeal can be used in children but it does not have a rear cuff. This study compared the LMA-ProSeal and the LMA-Classic in children for ease of insertion, airway sealing pressure and fibre-optic visualization. Sixty ASA I-II children undergoing herniorrhaphy, orchiopexy or myringotomy were included. The patients were randomly assigned to size 2 LMA-Classic trade mark or size 2 LMA-ProSeal groups for airway management. We assessed success rates at first attempt of insertion, airway sealing pressure, fibre-optic position, success rates of gastric tube placement and postoperative blood staining of the device, tongue-lip-dental trauma and hoarseness. There was no statistical difference between the two groups for the success rates at first attempt of insertion, airway sealing pressure and fibre-optic position. Gastric tube insertion was successful in 90% of cases in the LMA-ProSeal group. The LMA-Classic had a higher rate of postoperative blood staining, but there was no tongue-lip-dental trauma or hoarseness in either group. We conclude that ease of insertion and airway sealing pressure are similar between the LMA-ProSeal and the LMA-Classic in children.

Initial anatomic investigations of the I-gel airway: A novel supraglottic airway without inflatable cuff

Article

Oct 2005

The I-gel airway is a novel supraglottic airway that uses an anatomically designed mask made of a gel-like thermoplastic elastomer. We studied the positioning and mechanics of this new device in 65 non-embalmed cadavers with 73 endoscopies (eight had repeat insertion), 16 neck dissections, and six neck radiographs. A full view of the glottis (percentage of glottic opening score 100%) occurred in 44/73 insertions, whereas only 3/73 insertions had epiglottis-only views. Including the eight repeat insertions with a different size, a glottic opening score of > 50% was obtained in all 65 cadavers. The mean percentage of glottic opening score for the 73 insertions was 82% (95% confidence interval 75-89%). In each of the neck dissections and radiographs the bowl of the device covered the laryngeal inlet. We found that the I-gel effectively conformed to the perilaryngeal anatomy despite the lack of an inflatable cuff and it consistently achieved proper positioning for supraglottic ventilation.

Comparison of Clinical Performance of I-Gel™ with LMA—Proseal™ in Elective Surgeries

Abstract

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