A study to evaluate fibreoptic-guided intubation through the i-gel™

Abstract

Objective: The i-gel ™ superglottic airway (Intersurgical, Berkshire, UK) has been reported to function as an airway rescue device and as a conduit for fibre-optic intubation in predicted difficult airways. The wider and shorter stem of the i-gel ™ and the absence of a grille at the distal end suggests that it may serve as an ideal channel for intubation using a fibrescope. The aim of this prospective study was to determine the feasibility of using fibreoptic-guided intubation through an i-gel ™ airway in adult patients undergoing elective surgery. Design: A prospective clinical study. Subjects and setting: Sixty patients of both genders, aged 18-60 years, who presented for elective surgery in a tertiary care centre, were enrolled in the study. Outcome measures: The number of insertion attempts, ease of insertion and insertion time of the i-gel™, fibreoptic view through the i-gel ™ tube, airway seal pressure, ease of tracheal tube placement with the help of a fibreoptic bronchoscope through the i-gel ™, time taken for tracheal tube placement and any evidence of airway injury, were determined. Results: Successful insertion of the i-gel ™was achieved in 96.66% of patients. The mean time of insertion of the i-gel ™ was 9.09 ± 4.17 seconds. Ease of tracheal tube placement via the i-gel ™ was found to be easy in 91.4% of cases. The mean total tracheal tube placement time through the i-gel ™ was recorded as 89.16 ± 8.29 seconds. Conclusion: The i-gel ™ was easy to insert, with a good first attempt success rate and acceptable insertion time. The success rate for fibreoptic-guided intubation through the i-gel™ was also acceptable. Hence it can serve as an alternative conduit for fibreoptic-guided intubation. © SASA.