I-gel against proseal laryngeal mask airway and endotrachealtube during minor surgical procedures: a comparative study

BackgroundI-gel is the second generation of supraglottic airway devices with a noninflatable cuff that has several potential advantages over other supraglottic airway devices.ObjectiveThe aim of this study was to compare I-gel with proseal laryngeal mask airway (PLMA) and endotracheal tube (ETT) during elective minor surgical procedures using controlled ventilation. Design and settingA prospective, randomized, comparative study.Patients and methods A total of 60 adult female patients ASA I–II scheduled for elective breast lumpectomy surgery under general anesthesia with positive pressure ventilation were divided equally into three groups (20 patients each): group I used I-gel, group II used PLMA, and group III used ETT for airway maintenance. The three devices were compared with regard to the insertion characteristics, the ease of gastric tube insertion, tidal volumes, leak volumes, airway sealing pressures, hemodynamics, gas exchange parameters, and postoperative airway complications. ResultsThe mean insertion time for I-gel (9.8 ± 2.5 s) was significantly shorter than that of PLMA(15.4 ± 3.2 s) and ETT (14.1 ± 2.1 s) (P 0.001). The I-gel group (19/20) and the ETT group (18/20) showed a significantly easier insertion compared with the PLMA group (13/20) (P 0.05). There was a significant increase in the mean arterial blood pressure after the insertion of the airway device in the ETT group (110 ± 13 mmHg) compared with the I-gel group (100 ± 10 mmHg) and the PLMA group (102 ± 11 mmHg) (P 0.05). There was a significantly lower incidence of hoarseness, nausea, regurge, vomiting, and dysphagia in the I-gel and the PLMA groups when compared with the ETT group.ConclusionI-gel is an effective alternative device to PLMA and ETT during minor surgical procedures using controlled ventilation as it produces minimal hemodynamic changes, less airway morbidity,and is rapid and easy to insert.