A comparative study to assess I-gel as an alternative to endotracheal tube in laparoscopic surgeries

Athar Un Nisa Quraishi; Akshi Goel; Kamran Ahmad Quraishi; Touseef Ul Ayoub

doi:10.18203/2320-6012.ijrms20231632

Authors

Athar Un Nisa Quraishi Department of Anaesthesiology, GS Medical College Hapur, Ghaziabad, Uttar Pradesh, India
Akshi Goel Department of Anaesthesiology, Sir Gangaram Hospital, Delhi, India
Kamran Ahmad Quraishi Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
Touseef Ul Ayoub Department of Pediatric, Cardiology Fortis Escort Heart Institute, Okhla, Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231632

Keywords:

Endotracheal tube, Intubation, I-gel, Laparoscopic surgery, Pneumoperitoneum

Abstract

Background: This study was conducted to compare and evaluate the effectiveness of I-gel over endotracheal tube with regards to respiratory and hemodynamic parameters in laproscopic surgeries.

Methods: In this study 60 adult patients of either sex, of ASA status I or II, aged 16 to 60 years, undergoing laparoscopic surgeries under general anesthesia were randomly studied. In Group-A (I-gel) appropriate sized I-gel was inserted, and in Group-B (ETT) patient’s airway was secured with laryngoscopy-guided endotracheal intubation. Monitoring of PR, MBP, SpO₂ and EtCO₂ was done throughout the peri-operative period. Haemodynamic and ventilatory parameters were recorded before induction (baseline), just after intubation, then at 1, 3 and 5 min after I-gel insertion/intubation, after pneumoperitoneum, after change of position, before and 5 min after release of pneumoperitoneum and after I-gel removal/extubation.

Results: Following the insertion of airway device there was significant rise in PR (3 min after intubation [P = 0.011, df-58, CI-95%]) and MBP (3 min after intubation [P = 0.02, df-58, CI-95%], 5 min after intubation [P = 0.04, df-58, CI-95%]) in Group-B patients when compared to Group-A patients. Following insertion of airway device there was no significant difference in EtCO₂ (3 min after intubation [P = 0.778, df-58, CI-95%]), 5 min after intubation [P = 0.75, df-58, CI-95%]) in Group-B patients when compared to Group-A patients.

Conclusions: I-gel requires less time for insertion with minimal haemodynamic changes when compared to ETT. I-gel can be a safe and suitable alternative to ETT for laparoscopic surgery.

Metrics

Metrics Loading ...

References

Richez B, Saltel L, Banchereau F, Torrielli R, Cros AM. A new single use supraglottic airway device with a noninflatable cuff and an esophageal vent: An observational study of the i-gel. Anesth Analg. 2008;106:1137-9.

Castle N, Owen R, Hann M, Naidoo R, Reeves D. Assessment of the speed and ease of insertion of three supraglottic airway devices by paramedics: a manikin study. Emerg Med J. 2010;27(11):860-3.

Cork RC, Depa RM, Standen JR. Prospective comparison of use of the laryngeal mask and endotracheal tube for ambulatory surgery. Anes Analg. 1994;79(4):719-27.

Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002;88(4):582-4.

Maltby JR, Beriault MT, Watson NC, Liepert DJ, Fick GH. LMA-Classic and LMA-ProSeal are effective alternatives to endotracheal intubation for gynecologic laparoscopy. Can J Anaesth. 2003;50:71-7.

Abdi W, Amathieu R, Adhoum A, Poncelet C, Slavov V, Kamoun W, et al. Sparing the larynx during gynecological laparoscopy: a randomized trial comparing the LMA Supreme and the ETT. Acta Anaesthesiol Scand. 2010;54(2):141-6.

Teoh WH, Lee KM, Suhitharan T, Yahaya Z, Teo MM, Sia AT. Comparison of the LMA Supreme vs the i-gel in paralysed patients undergoing gynaecological laparoscopic surgery with controlled ventilation. Anaesthesia. 2010;65(12):1173–9.

Ali A, Canturk S, Turkmen A, Turgut N, Altan A. Comparison of the laryngeal mask airway Supreme and laryngeal mask airway Classic in adults. Eur J Anaesthesiol. 2009;26(12):1010-4.

Wharton NM, Gibbison B, Gabbott DA, Haslam GM, Muchatuta N, Cook TM. I-gel insertion by novices in manikins and patients. Anaesthesia. 2008;63(9):991–5.

Theiler LG, Kleine-Brueggeney M, Luepold B, Stucki F, Seiler S, Urwyler N, Greif R. Performance of the pediatric-sized i-gel compared with the Ambu AuraOnce laryngeal mask in anesthetized and ventilated children. Anesthes. 2011;115(1):102–10.

Levitan RM, Kinkle WC. Initial anatomic investigations of the I-gel airway: a novel supraglottic airway without inflatable cuff. Anaesthesia. 2005;60(10):1022-6.

Komasawa N, Nishihara I, Tatsumi S, Minami T. Prewarming of the i-gel facilitates successful insertion and ventilation efficacy with muscle relaxation: a randomized study. J Clin Anesth.2014;26(8):663-7.

Misra MN, Ramamurthy B. The Pro-Seal LMAtm and the tracheal tube: A comparison of events at insertion of the airway device. Internet J Anesthesiol. 2008;16(2).

Sharma B, Sehgal R, Sahai C, Sood J. PLMA vs. I-gel: A comparative evaluation of respiratory mechanics in laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2010;26(4):451-7.

Uppal V, Gangaiah S, Fletcher G, Kinsella J. Randomized crossover comparison between the i-gel and the LMA-Unique in anaesthetized, paralysed adults. Br J Anaesth. 2009;103(6):882-5.

Helmy AM, Atef HM, El-Taher EM, Henidak AM. Comparative study between I-gel, a new supraglottic airway device, and classical laryngeal mask airway in anesthetized spontaneously ventilated patients. Saudi J Anaes. 2010;4(3):131.

Jindal P, Rizvi A, Sharma JP. Is i-gel a new revolution among supraglottic airway devices. Department of Anesthesiology American University of Beirut Medical Center PO Box 11-0236. Beirut 1107-2020, Lebanon. 2009;20(1):53.

Uppal V, Fletcher G, Kinsella J. Comparison of the i-gel with the cuffed tracheal tube during pressure-controlled ventilation. British J Anaes. 2009;102(2):264-8.