Online ISSN: 2515-8260

Keywords : I-gel


COMPARISON OF INTUBATION RESPONSE OF I GEL AND LARYNGEAL MASK AIRWAY UNDER SEVOFLURANE ANAESTHESIA IN PEDIATRIC PATIENTS

T. Balaji, Anjaneya Varaprasad S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3067-3082

Background: This study aims to compare insertion parameters, ventilatory parameters, hemodynamic parameters and post-removal complications that occur during LMA insertion and I-gel insertion in pediatric patients for surgical procedures under sevoflurane anesthesia. Supraglottic airway devices are increasingly being used in children as they are less invasive than endotracheal intubation and cause less discomfort in the post-operative period.
Materials and Methods: In our study, 60 children ASA grade I & II aged between 1-5years, scheduled for elective short surgical procedures were allotted to two groups LMA and I-gel of 30 patients each randomly. The efficacy of I-gel in children during intubation, its hemodynamic changes and post-operative complications were compared to LMA under sevoflurane anaesthesia.
Results: I-gel insertion was done easily in 93.3% patients while LMA insertion was done easily in 86.67% patients. The changes in hemodynamic parameters i.e., heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were not statistically significant between both the groups (p>0.05). Saturation of haemoglobin is maintained above 97% with both devices which shown no statistical significance. Incidence of postoperative complications like cough, laryngospasm, lip/dental injury were comparable between both the groups with p>0.05. However, there was a substantial difference in the incidence of postoperative sore throat between both the groups, with the LMA group having a greater frequency.
Conclusion: In conclusion, neither LMA nor I-gel induces any substantial changes in the patients' hemodynamic condition, nor does SPO2. The postoperative complications in LMA and I-gel patients are not considerably different. I-gel insertion is substantially easier and faster than LMA insertion.

Comparison of Efficacy of i-gel and Baska Mask as Ventilatory Device in Anaesthetised Patients

Kaushal Pandey, Aditya Kumar Chauhan, Pooja Hatwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2385-2392

Background:Supraglottic-airway devices (SAD) are divided into first-generation and second-generation devices. Baska Mask and i-gel device are the two commonly used second-generation SADs in anaesthetic practice. This study compares the i-gel and Baska Mask in terms of efficacy and safety as a ventilatory device in anaesthetized patients undergoing elective surgeries.
Materials and Methods: The study was carried out in Department of Anaesthesiology, Government Medical College and Dr.Sushila Tiwari Hospital, Haldwani. Patients were allocated into 2 groups: Group A (i-gel, n=35) and Group B (Baska Mask, n=35). All patients were pre-oxygenated for 3-minutes and anaesthesia was induced. Successful insertion of the device was confirmed by chest wall movement, auscultation of breath sounds and square wave capnographic tracing. At the end of the surgical procedure, anaesthesia was discontinued and patients were reversed with the standard dose of neostigmine and glycopyrrolate after proper suctioning. Complications, if any were noted after 2 hours and 24 hours period.
Results: The mean age of the study population was 35.83±9.50 years. Among i-gel group, there were 24 (68.6%) males and 11 (31.4%) females. Among Baska Mask group, there were 20 (57.1%) males and 15 (42.9%) females. The percentage of patients with easy insertion was 80% and 68.6% for i-gel and Baska Mask respectively. The mean time taken for SAD was significantly more among Baska Mask (24.49±4.39) in comparison to i-gel (16.19±2.38). Sore throat at 2 hours was seen in 3 (8.6%) and 2 (5.7%) patients of i-gel and Baska Mask group respectively. Dysphagia at 2 hours was seen in 2 (5.7%) and 1 (2.9%) patient of i-gel and Baska Mask group respectively, while dysphagia at 24 hours was seen in 1(2.9%) patient of i-gel group only, also hoarseness at 2 hours was seen in 1(2.9%) patient of i-gel group. Incidence of all the complications reported with i-gel and Baska Mask group were comparable.
Conclusion: This study demonstrated that both Baska Mask and i-gel provided a similar performance in airway management. In terms of the total time taken for insertion, i-gel has a lesser time of insertion than the Baska mask. The success rate of insertion of Baska Mask and i-gel was comparable and ease of insertion was also comparable. Complications observed in both devices were minimal.

Comparision of i-gel and cLMA for oropharyngeal seal pressure and peak airway pressure in paediatric patients

Dr Nimish Jain, Dr Susheela Taxak

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5570-5580

The i-gel in paediatric patients is a single use supraglottic airway which was officially
launched for use in January 2010. This device differs from other supraglottic airways in that
it has an anatomically designed mask made up of thermoplastic elastomer & the cuff which
does not require inflation with air. Evaluation of i-gel in adult patient has shown that it is easy
to insert and provides an effective airway in majority of patients. We conducted a
prospective, randomized, single blind study to compare i-gel and cLMA in the Indian
paediatric population of age group from six months to 8 years belonging to ASA physical
status I or II, scheduled to undergo elective surgery under general anaesthesia. We analysed igel
with cLMA of paediatric sizes for peak airway pressures and oropharyngeal seal pressure.
And we found i-gel provides better OSP and lower PAP than cLMA making this better
device for controlled ventilation.

Evaluation of the Efficacy of I-gel Supraglottic Airway Device in Relation to Ease of Insertion, Time Taken to Establish Effective Ventilation and Gastric Insufflation

Akhilesh Mishra, Vineet Mishra, Vrushali Moharil, Abha Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5712-5718

Introduction: I-gel is a novel supraglottic airway device with anatomically designed,
non-inflatable mask, which is soft gel like and transparent made of medical grade
thermoplastic elastomer called styrene ethylene butadiene styrene.The present study is
carried out to evaluate the efficacy of I-gel with regard to easiness of insertion of I-gel,
number of insertion attempts, time taken and maneuvers required; time taken to
establish effective ventilation and gastric insufflation.
Material and Methods: A prospective randomized controlled study was conducted on 40
patients scheduled for elective surgical procedures and requiring controlled ventilation.
Patients were induced with thiopentone 4-6 mg/kg. Size 3 I-gel was used in patients
weighing 30-60 kg and size 4 I-gel was used in patients weighing 60-90 kg. Correct I-gel
insertion was assessed clinically by subjective assessment of appropriate length of
airway tube outside the mouth, gastric insufflation and adequacy of manual ventilation
which was assessed by proper chest expansion and presence of CO2 waveform.
Results: The study included the patients with MMP classI/II and ASA grade I/II. The
mean time taken for insertion was 14.75±1.48 seconds and 95% patients required single
attempt for successful device insertion and 5% patients required second attempt for
successful device insertion. In two patients head tilt and chin lift maneuver was used for
the correct placement of the device.In 38(95%) patients the insertion of the I-gel was
scores very easy(grade1) and in 2(5%) patients it was scored easy(grade 2).
Conclusion: I-gel is an effective supraglottic airway device which can be rapidly
inserted. It provides a leak free glottis seal during positive pressure ventilation. The
nasogastric tube can be easily placed

A Study to Observe the Hemodynamic Changes Following Insertion of I-gel and to Access Incidence of Any Postoperative Side Effects

Vineet Mishra, Akhilesh Mishra, Abha Singh, Vrushali Moharil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5803-5811

Introduction: Supraglottic airway devices (SADs) are used to keep the upper airway
open to provide unobstructed ventilation. I-gel is a second generation extraglottic
airway device. SADs now provide successful rescue ventilation in > 90% of patients in
whom mask ventilation or tracheal intubation is found to be impossible.The present
study was carried to observe the hemodynamic changes following insertion of I-gel and
to evaluate any incidence of post – operative sore throat or any other side effects.
Material and Methods: A prospective randomized controlled study was conducted on 40
patients scheduled for elective surgical procedures and requiring controlled ventilation.
Patients were induced with thiopentone 4-6 mg/kg. Size 3 I-gel was used in patients
weighing 30-60 kg and size 4 I-gel was used in patients weighing 60-90 kg. Correct I-gel
insertion was assessed clinically by subjective assessment of appropriate length of
airway tube outside the mouth, gastric insufflation and adequacy of manual ventilation
which was assessed by proper chest expansion and presence of CO2 waveform.
Results: Slight rise in MAP of 97.58±9.29 mmHg from BL value of 93.13±9.03 was
observed (p=0.836). The mean %age rise was 4.66±2.83 after insertion of the I-gel in
comparison with the base line value. It was found to be statistically insignificant.
Oxygen saturation was maintained between 99-100% for all the patients till the end of
the surgery. There was not any significant change in the ETCO2 after I-gel insertion. As
revealed from the data there was very less incidence of post-operative complications.
Two patients complained of sore throat at 6 hours and 24 hours post-operatively.