Evaluating the Clinical Performance and Upper Airway Morbidity of I-Gel and its Comparison with Proseal Laryngeal Mask Airway- A Randomised Controlled Trial UC01-UC05
MS Ramaiah Medical College, MSR Nagar, Bangalore-560054, Karnataka, India.
Introduction: Studies comparing the efficiency of i-gel against Proseal Laryngeal Mask Airway (PLMA) have reported that both devices can maintain adequate airway sealing pressure, thus facilitating controlled ventilation. However, studies on postoperative events in the Indian context are quite rare.
Aim: To evaluate i-gel against PLMA in terms of insertion characteristics, haemodynamic response, airway seal pressure, Minimum Minute Ventilation (MMV) and upper airway morbidity.
Materials and Methods: Sixty-six patients were randomised to receive PLMA (Group P=33) or i-gel (Group I=33) for airway management. Demographic and operative data were recorded. Patient vitals including heart rate, systolic/diastolic blood pressures, peripheral capillary oxygen saturation and end-tidal carbon dioxide were measured. Airway sealing pressure and MMV were noted after device insertion. Postoperative upper airway morbidities observed (cough, sore throat, hoarseness of voice, dysphagia, odynophagia, and dysphonia) were noted (%). ANOVA, Mann-Whitney and chi-square tests were employed to analyse the data.
Results: Demographic data including clinical characteristics were comparable in both groups. Airway seal pressures (p=0.05) and MMV (p≥0.05) were also similar in either group. Haemodynamic responses also showed no significant differences. Postoperative airway morbidities were similar in both groups (p>0.05 except odynophagia with p<0.05) and although a higher incidence was observed in the PLMA group compared to the i-gel group, the difference was statistically insignificant.
Conclusion: PLMA and i-gel were both found to be efficient supraglottic airway devices for intraoperative airway maintenance, while the incidence of postoperative airway morbidities was lesser in the i-gel group. Significantly low incidence of blood on device and high airway seal pressure in the i-gel group indicates that i-gel may be an ideal alternative to PLMA among patients undergoing elective surgeries under controlled ventilation.