I-gel™ supraglottic airway in clinical practice: A prospective observational multicentre study

Abstract

BackgroundThe i-gel™ supraglottic airway device has been studied in randomized controlled studies, but it has not been evaluated in a large prospective patient cohort. Therefore, we performed this prospective multicentre observational study to evaluate success rates, airway leak pressure, risk factors for i-gel failure, and adverse events.MethodsWith Ethics Committee approval and waiver of patients' consent, data about anaesthesia providers, patient characteristics, and the performance of the i-gel were recorded in five independent hospitals in Switzerland over a period of 24 months. We analysed success rates, leak pressures, adverse events, and risk factors for failure.ResultsData from 2049 i-gel uses were analysed. Patients' mean age was 47 (range 6-91) yr. The primary i-gel success rate without changing size was 93; the overall success rate was 96. Insertion was deemed very easy or easy in 92. The mean airway leak pressure was 26 (8) cm H2O. The mean anaesthesia time was 67 (42) min. Risk factors associated with i-gel failure were males (P<0.001), impaired mandibular subluxation (P0.01), poor dentition (P0.02), and older age (P<0.01). Adverse events recorded were laryngeal spasms (n25, 1.2), blood stained airway devices (n79, 3.9), transient nerve damage (n2, 0.1), one case of transient vasovagal asystole, and one glottic haematoma. ConclusionsThe i-gel is a reliable supraglottic airway device failing in <5 and providing high airway leak pressures. Males, impaired mandibular subluxation, poor dentition, and older age are risk factors associated with primary device failure. Serious adverse events are rare. © 2012 The Author [2012].