Evaluating the Clinical Performance and Upper Airway Morbidity of I-Gel and its Comparison with Proseal Laryngeal Mask Airway- A Randomised Controlled Trial

Abstract

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 post-operative 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. Post-operative upper airway morbidities, (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 both group. Haemodynamic responses also showed no significant differences. Post-operative 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 post-operative 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.

Keywords

• airway management
• anaesthesia
• dysphagia
• intubation
• morbidities
• sore throat