Evaluation of the I-gel, a supraglottic airway device in children undergoing day care surgery

Background: The i-gel is a novel supraglottic airway device, made up of medical grade thermoplastic elastomer. Its soft noninflatable cuff causes easier insertion, minimal tissue compression and stability after insertion. An integral gastric channel is provided for passage of gastric drainage tube to empty the stomach. Materials and Methods: We evaluated i-gel in sizes ranging from 1.5 to 2.5 in pediatric patients considered suitable for a supraglottic device. We assessed ease of insertion, insertion time, ease of insertion of gastric drain tube, adequacy of ventilation, oropharyngeal leak pressure and complications with the use of the device. Results: We studied the use of the i-gel in 120 anaesthetized children with a mean age 5.2 years and weight 16.96 kg to assess its safety and efficacy. First insertion attempt was successful in 94.11% of patients. The mean time to insertion was 9.5 s. Ease of insertion score of i-gel airway device was Grade I/Grade II/Grade III in 90.83%/8.33%/0.83% patients respectively. Ease of insertion score for gastric drainage tube through device was Grade I/Grade II in 99.16%/0.83% of patients. Mean oropharyngeal leak pressure was 20 cm of H 2 O. Intraoperatively six patients required manipulation to improve the airway and two patients had minor complications in the postoperative period. Analysis of the difference among the three sizes of i-gel was performed using the Chi-square test, fisher′s exact test and one-way ANOVA test. Statistical analysis revealed no significant difference in a number of insertion attempts, ease of insertion score for i-gel and gastric drainage tube, insertion time, intraoperative and postoperative complications among the various sizes of i-gel. Conclusion: The i-gel was inserted without complications, establishing a clear airway and enabling spontaneous and controlled ventilation in majority of patients. This device is easy to use and has low pharyngolaryngeal morbidity