Conventional versus reverse insertion of i-gel® in overweight and obese patients - Interventional randomised controlled trial

Background and Aims:The supraglottic airway device, i-gel, is used in obese patients for short- to medium-duration surgical procedures. Insertion techniques have contributed to the successful and proper placement of i-gel in the first attempt. This study aims to compare two techniques for successfully inserting i-gel in the first attempt in overweight and obese patients as measured by oropharyngeal leak pressure (OLP).Methods:This interventional, randomised, controlled study was conducted after ethical approval, and trial registration in overweight and obese patients. Patients were randomised into two groups: In Group C, the conventional technique was used, while in Group R, the reverse technique was used to insert i-gel. OLP, successful placement, required manipulations, time taken for insertion, number of attempts, and intraoperative and postoperative complications were studied. The collected data were analysed statistically.Results:The mean OLP (30.46 & PLUSMN; 3.76 vs. 32.12 & PLUSMN; 3.10 mmHg, P = 0.018) and the mean time of insertion (16.42 & PLUSMN; 1.86 vs. 13.98 & PLUSMN; 1.97 s, P = 0.001) for conventional and reverse techniques, respectively, were statistically significant and favourable for Group R compared to Group C. Successful placement of i-gel at the first attempt, ease of insertion, number of attempts and all the manipulations except withdrawal and advancement were comparable in both the groups. No postoperative complications were noted.Conclusion:The reverse technique significantly favoured the actual OLP values and the mean insertion time. Successful placement of i-gel at the first attempt was observed with both conventional and reverse techniques.