DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20195525

A comparative evaluation of I-gel and laryngeal mask airway supreme in laparoscopic surgeries: a randomized comparative study

Reetu Verma, Nitin Kumar, Hemlata ., Sateesh Verma, Dinesh Singh

Abstract


Background: Supraglottic airway device results in less hemodynamic responses during laparoscopic surgery but supraglottic airway device to be used should have higher oropharyngeal seal pressure than peak pressure for effective ventilation as laparoscopic surgery also leads to higher airway pressure. In this study the efficiency of the I-gel with SLMA is compared in patients undergoing laparoscopic cholecystectomy surgeries.

Methods: Sixty patients were randomized in to two groups, group A where I-gel was considered for airway management and group B where LMA Supreme was the device chosen for airway management.

Results: Oropharyngeal seal pressure was significantly lower in group A than group B, 5 minutes after insertion of airway device it was 24.90±3.03 cm H2O and 27.30±3.41 cm H2O in group A and group B, respectively and 5 minutes after creation of pneumoperitoneum it was 25.53±3.17 cm H2O and 27.57±3.36 cm H2O in group A and group B, respectively. There was significant difference in the difference between inspiratory and expiratory tidal volume between the groups at all the time periods being higher in group A than group B. Hemodynamics were comparable between the two groups. Time taken to insert the airway device and Ryle’s tube insertion was significantly lesser in group B in comparison to group A. The percentage of complications was higher in group A than group B with no significant (p>0.05) association.

Conclusions: Both the I-gel and SLMA devices can be used safely in laparoscopic cholecystectomy in non-obese patients. But in SLMA group oropharyngeal seal pressure was higher with lesser leak volume in comparison to I-gel group.


Keywords


Cholecystectomy, I-gel, Laparoscopic surgery, Laryngeal mask airway supreme

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References


Dorsey DP, Joffe AM. Physiologic and Pathophysiologic Responses to Intubation. In Hagberg CA, Artime CA. Airway Management in the adult. 4th edition. Philadelphia, PA: Elsevier;2018:166.

Ismail SA, Bisher NA, Kandil HW, Mowafi HA, Atawia HA. Intraocular pressure and haemodynamic responses to insertion of the I-gel, laryngeal mask airway or endotracheal tube. Eur J Anaesthesiol. 2011 Jun 1;28(6):443-8.

Badheka JP, Jadliwala RM, Chhaya VA, Parmar VS, Vasani A, Rajyaguru AM. I-gel as an alternative to endotracheal tube in adult laparoscopic surgeries: A comparative study. J Minimal Access Surg. 2015 Oct;11(4):251.

Biswas S, Mandal S, Mitra T, De Ray S, Chandra R, Sur D. A prospective randomized comparative study to compare the hemodynamic and metabolic stress respone due to endotracheal intubation and I-gel usage during laparoscopic cholecystectomy. Middle East J Anaesthesiol. 2015 Oct;23(3):315-20.

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

Vaida S, Gaitini L and Frass M. Supraglottic Airway Techniques: Nonlaryngeal Mask Airways. In Hagberg C. Hagberg and Benumof's Airway Management. 4th edition. Philadelphia, PA: Elsevier;2018:364-365.

Jindal P, Rizvi A, Sharma JP. Is I-Gel a new revolution among supraglottic airway devices? A comparative evaluation. Middle East J Anesthesiol. 2009; 20:53-8.

Fernández AD, Pérez AV, Bermejo JG, Marcos JV. Supreme laryngeal mask airway vs the I-gel supraglottic airway in patients under general anesthesia and mechanical ventilation with no neuromuscular block: a randomized clinical trial. Revista Espanola De Anestesiol Reanimacion. 2009 Oct;56(8):474-8.

Ragazzi R, Finessi L, Farinelli I, Alvisi R, Volta CA. LMA Supreme™ vs i‐gel™–a comparison of insertion success in novices. Anaesthesia. 2012 Apr;67(4):384-8.

Radhika KS, Sripriya R, Ravishankar M, Kumar VH, Jaya V, Parthasarathy S. Assessment of suitability of I-gel and laryngeal mask airway-supreme for controlled ventilation in anesthetized paralyzed patients: A prospective randomized trial. Anesthesia, essays and researches. 2016 Jan;10(1):88.

Beleña JM, Núñez M, Anta D, Carnero M, Gracia JL, Ayala JL, et al. Comparison of Laryngeal Mask Airway Supreme and Laryngeal Mask Airway Proseal with respect to oropharyngeal leak pressure during laparoscopic cholecystectomy: a randomised controlled trial. Euro J Anaesthesiol (EJA). 2013 Mar 1;30(3):119-23.

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 Dec;65(12):1173-9.

Park SY, Rim JC, Kim H, Lee JH, Chung CJ. Comparison of I-gel® and LMA Supreme® during laparoscopic cholecystectomy. Kor J Anesthesiol. 2015 Oct;68(5):455.

Mukadder S, Zekine B, Erdogan KG, Ulku O, Muharrem U, Saim Y, et al. Comparison of the proseal, supreme, and I-gel SAD in gynecological laparoscopic surgeries. Sci World J. 2015.

Chew EF, Hashim NH, Wang CY. Randomised comparison of the LMA Supreme™ with the I-Gel™ in spontaneously breathing anaesthetised adult patients. Anaesthesia intensive care. 2010 Nov;38(6):1018-22.

Lai CJ, Liu CM, Wu CY, Tsai FF, Tseng PH, Fan SZ. I-Gel is a suitable alternative to endotracheal tubes in the laparoscopic pneumoperitoneum and trendelenburg position. BMC Anesthesiol. 2017 Dec;17(1):3.

Theiler LG, Kleine-Brueggeney M, Kaiser D, Urwyler N, Luyet C, Vogt A, et al. Crossover comparison of the laryngeal mask supreme™ and the i-gel™ in simulated difficult airway scenario in anesthetized patients. Anesthesiology: J Am Soc Anesthesiol. 2009 Jul 1;111(1):55-62.

Liew GH, Yu ED, Shah SS, Kothandan H. Comparison of the clinical performance of I-gel, LMA Supreme and LMA ProSeal in elective surgery. Singapore Med J. 2016 Aug;57(8):432.

Van Zundert TC, Brimacombe JR. Similar oropharyngeal leak pressures during anaesthesia with I-gelTM, LMA-ProSealTM and LMA-SupremeTM Laryngeal Masks. Acta Anaesthesiol Belgica. 2012 Jan 1;63(1):35-41.