A randomized trial to compare thenar eminence dimensions-based method with body weight method to determine I-gel size in pediatric patients

Abstract

Background: In pediatric daycare surgery, I gel has been used safely and effectively in anesthetized children. I-gel size is determined routinely by the manufacture's recommended weight-based method. The dimension of thenar eminence can help in determining I-gel size. The aim of this study was to compare the weight-based method and thenar eminence dimension method in the selection of I gel. Subjects and Methods: The prospective, randomized, single-blind study included 80 patients of the age group 6 months to 12 years, the American Society of Anesthesiologists class I, II, and III of either gender who were undergoing surgery under general anesthesia. Group 1– (n = 40) recommended weight-based method and group 2 – (n = 40) thenar eminence-based method. Parameters observed were proper placement, adequate ventilation, leak fraction (LF), and number of attempts. Results: Proper placement and adequate ventilation were comparable between two groups. LF is statistically higher in group 1 compared to group 2 (P = 0.003). The mean insertion time was 17 s in each group. The number of attempts, hemodynamic parameters, and ease of insertion were all comparable between two groups. Conclusions: Thenar eminence dimension can be the better method for the recommended weight-based method, especially in the emergency situations when the weight cannot be determined.

Keywords

• i gel
• leak fraction
• pediatric patients
• thenar eminence