Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1016/j.bjane.2014.02.009
Brazilian Journal of Anesthesiology
Scientific Article

Comparison of the i-gelTM and the Laryngeal Mask Airway ClassicTM in terms of clinical performance

Comparação da máscara laríngea i-gel (i-gelTM) com a máscara laríngea clássica (LMA-ClassicTM) em relação ao desempenho clínico

Reyhan Polat; Gözde Bumin Aydin; Jülide Ergil; Murat Sayin; Tuğ; ba Kokulu; Ibrahim Öztürk

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Abstract

ABSTRACTPURPOSE: The i-gelTM is one of the second generation supraglottic airway devices. Our study was designed to compare the i-gel and the Laryngeal Mask Airway ClassicTM with respect to the clinical performance.METHODS: We compared the performance of the i-gel with that of the Laryngeal Mask Airway Classic in 120 patients undergoing urologic surgery during general anesthesia without muscle relaxant with respect to the number of attempts for successful insertion, insertion time, peak airway pressure, incidence of regurgitation, fiberoptic glottic view and postoperative complications. Second generation supraglottic airway devices were inserted by the same anesthesiologist, experienced in use of both devices (>200 uses and first time failure rate <5%). Methylene blue method was used to detect gastric regurgitation.RESULTS: There was no statistical difference between the two groups regarding the success of insertion of second generation supraglottic airway device (p = 0.951). The laryngeal mask insertion time for the i-gel group was significantly shorter than that for the Laryngeal Mask Airway Classic group (11.6 ± 2.4 s versus 13.1 ± 1.8 s [p = 0.001]). The fiberoptic glottic view scores for the i-gel group was significantly better than that for the ones for the Laryngeal Mask Airway Classic group (p = 0.001). On fiberoptic view, there was no sign of methylene blue dye at any time point in either group. In addition, there was no difference between the groups in patient response regarding the presence of a sore throat when questioned 24 h after the procedure (p = 0.752).CONCLUSION: Both devices had good performance with low postoperative complications and without occurrence of regurgitation. The i-gel provided a shorter insertion time and a better fiberoptic view than the Laryngeal Mask Airway Classic.

Keywords

Laryngeal Mask Airway Classic, i-gel, Supraglottic airway devices

Resumo

RESUMOJUSTIFICATIVA E OBJETIVO: A i-gel é um dos dispositivos supraglóticos de segunda geração para o manejo das vias aéreas. Nosso estudo foi projetado para comparar a i-gelTM e a máscara laríngea clássica (Laryngeal Mask Airway ClassicTM, LMA-C) em relação ao desempenho clínico.MÉTODOS: Avaliamos os desempenhos de i-gel e LMA-C em 120 pacientes submetidos à cirurgia urológica sob anestesia geral sem relaxante muscular. Comparamos o número de tentativas de inserção bem-sucedidas, o tempo de inserção, a pressão de pico das vias aéreas, a incidência de regurgitação, a visibilidade da glote com o uso de fibra óptica e as complicações no pós-operatório. Os dispositivos supraglóticos de segunda geração foram inseridos pelo mesmo anestesiologista com experiência na aplicação de ambos os dispositivos (> 200 aplicações e taxa de falha na primeira tentativa < 5%). O corante azul de metileno foi usado para detectar regurgitação gástrica.RESULTADOS: Não houve diferença estatística entre os dois grupos em relação ao sucesso da inserção do dispositivo supraglótico de segunda geração (p = 0,951). O tempo de inserção da máscara laríngea no grupo i-gel foi significativamente menor do que no grupo LMA-C (11,6 ± 2,4 segundos vs. 13,1 ± 1,8 segundos, p = 0,001). O escore de visibilidade da glote via fibra óptica do grupo i-gel foi significativamente melhor do que o do grupo LMA-C (p = 0,001). Na visão via fibra ótica, sinais do corante azul de metileno não foram observados em qualquer momento em ambos os grupos. Além disso, não houve diferença entre as respostas dos grupos quando perguntados sobre a presença de dor de garganta 24 horas após o procedimento (p = 0,752).CONCLUSÃO: Ambos os dispositivos apresentaram bom desempenho, com poucas complicações no pós-operatório e sem ocorrência de regurgitação. A máscara laríngea i-gel proporcionou um tempo de inserção mais curto e uma visão via fibra óptica melhor do que a LMA-C.

Palavras-chave

Máscara laríngea clássica, i-gel, Dispositivos supraglóticos

References

Al Brain. The laryngeal mask-a new concept in airway manage- ment. Br J Anaesth. 1983;55:801-5.

Smith I, Joshi G. The laryngeal mask airway for outpatient anes- thesia. J Clin Anesth. 1993;5:22-8.

Mortensen CR, Jenstrup MT, Fruergard KO. The laryngeal mask: a new alternative to the facial mask and the endotracheal tube. Ugeskr Laeger. 1991;153:2542-4.

Miller DM. A proposed classification and scoring system for supraglottic sealing airways: a brief review. Anesth Analg. 2004;99:1553-9.

Brimacombe JR, Berry A. The incidence of aspiration associated with the laryngeal mask airway: a meta-analysis of published literature. J Clin Anesth. 1995;7:297-305.

Koehli N. Aspiration and the laryngeal mask airway. Anaesthesia. 1991;46:419.

Barker P, Murphy P, Longtan JA,. Regurgitaton of gastric contents during general anaesthesia using laryngeal mask air- way. Br J Anaesth. 1992;69:314-5.

Barker P, Murphy P, Longtan JA,. Regurgitaton of gastric contents during general anaesthesia using laryngeal mask air- way. Br J Anaesth. 1991;67:660.

Brimacombe J, Berry AA. Proposed fiber-optic scoring system to standardize the assessment of laryngeal mask airway position. Anesth Analg. 1993;76:457.

Kapila A, Addy EV, Verghese C,. The intubating laryn- geal mask airway: an initial assessment of performance. Br J Anaesth. 1997;79:710-3.

Gatward JJ, Cook TM, Seller C,. Evaluation of the size 4 i- gel airway in one hundred non-paralyzed patients. Anaesthesia. 2008;63:1124-30.

Ali A, Canturk S, Turkmen A,. Comparison of the laryn- geal mask airway Supreme and laryngeal mask airway classic in adults. Eur J Anaesthesiol. 2009;26:1010-4.

Richez B, Saltel L, Banchereau F,. 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.

Amini S, Khoshfetrat M. Comparison of the intersurgical solus laryngeal mask airway and the i-gel supralaryngeal device. Anaesthesia. 2010;65:805-9.

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

Jagannathan N, Sommers K, Sohn LE,. A randomized equiv- alence trial comparing the i-gel and laryngeal mask airway supreme in children. Paediatr Anaesth. 2013;23:127-33.

Theiler LG, Kleine-Brueggeney M, Kaiser D,. Crossover comparison of the laryngeal mask supreme and the i-gel in simulated difficult airway scenario in anesthetized patients. Anesthesiology. 2009;11:55-62.

Chen X, Jiao J, Cong X,. A comparison of the performance of the I-gel TM vs. the LMA-S TM during anesthesia: a meta-analysis of randomized controlled trials. PLoS ONE. 2013;12:e71910.

Teoh WH, Lee KM, Suhitharan T,. Comparison of the LMA supreme vs. the i-gel in paralysed patients undergoing gynaecological laparoscopic surgery with controlled ventilation. Anaesthesia. 2010;65:1173-9.

Wenzel V, Idris AH, Dörges V,. The respiratory system during resuscitation: a review of the history, risk of infection dur- ing assisted ventilation, respiratory mechanics, and ventilation strategies for patients with an unprotected airway. Resuscitation. 2001;49:123-34.

Brain AI, Brimacombe JR, Berry AM,. Reflux during positive pressure ventilation via the laryngeal mask airway?. Br J Anaesth. 1995;74:489-90.

Brimacombe J. Analyses of 1500 laryngeal mask uses by one anaesthetist in adults undergoing routine anaesthesia. Anaes- thesia. 1996;51:76-80.

Beringer RM, Kelly F, Cook TM,. A cohort evaluation of the paediatric i-gel TM airway during anaesthesia in 120 children. Anaesthesia. 2011;66:1121-6.

Rabey PG, Murphy PJ, Langton JA,, anaesthesia Effect of the laryngeal mask airway on lower oesophageal sphincter pres- sure in patients during general. Br J Anaesth. 1992;69:346-8.

Bapat P, Verghese C. Laryngeal mask airway and the incidence of regurtation during gynecological laparascopies. Anesth Analg. 1997;85:139-43.

Gibbison B, Cook TM, Seller C. Case series: protection from aspi- ration and failure of protection from aspiration with the i-gel airway. Br J Anaesth. 2008;100:415-7.

Joshi GP, Morrison SG, Okonkwo NA,. Continuous hypopharyngeal pH measurements in spontaneously breathing anesthetized outpatients: laryngeal mask airway versus tra- cheal intubation. Anesth Analg. 1996;82:254-7.

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