Comparison of supraglottic devices i-gel(®) and LMA Fastrach(®) as conduit for endotracheal intubation

Sameer Kapoor, Dharam Das Jethava, Priyamvada Gupta, Durga Jethava, Alok Kumar, Sameer Kapoor, Dharam Das Jethava, Priyamvada Gupta, Durga Jethava, Alok Kumar

Abstract

Background and aims: i-gel(®), a recently introduced supraglottic airway device (SAD) has been claimed to be an efficient supraglottic airway. It can also be used as a conduit for endotracheal intubation. However, LMA Fastrach(®) frequently used for this purpose; hence in this randomized study, success rate of blind tracheal intubation through two different SADs i-gel(®) and LMA Fastrach(®) was evaluated. The complications if any were also studied.

Methods: A total of 100 patients undergoing elective surgery under general anaesthesia were randomised in two groups comprising of 50 patients each to tracheal intubation using either i-gel (I group) or LMA Fastrach (F group). After induction of anaesthesia SAD was inserted and on achieving adequate ventilation with the device, blind tracheal intubation was attempted through the SAD. Success at first-attempt and overall tracheal intubation success rates were evaluated, and tracheal intubation time was measured. Data were analysed using IBM SPSS Statistics 20.0 software (Statistical Package for Social Sciences by International Business Machines Corporation). P < 0.05 was considered as statistically significant.

Results: There was no difference in the incidence of adequate ventilation with either of the SAD. The success rate of tracheal intubation in first attempt was 66% in Group I and 74% in Group F, while overall success rate of tracheal intubation was 82% in Group I when compared to 96% in Group F. Time taken for successful tracheal intubation through LMA Fastrach was lesser (20.96 s) when compared to i-gel (24.04 s). Complication rates were statistically similar in both the groups.

Conclusion: i-gel(®) is a better device for rescue ventilation due to its quick insertion but an inferior intubating device in comparison to LMA Fastrach(®).

Keywords: Blind intubation; external laryngeal manoeuvre; i-gel®; laryngeal mask airway Fastrach®.

Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Direction of bevel during blind intubation through i-gel causing impingement on right glottic structures
Figure 2
Figure 2
Direction of bevel after 90° counter clock rotation preventing impingement on glottic structures

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Source: PubMed

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