The supraglottic airway I-gel in comparison with ProSeal laryngeal mask airway and classic laryngeal mask airway in anaesthetized patients

Background and objective The I-gel is a new single-use supraglottic airway device without an inflatable cuff. This study was designed to investigate the usefulness of the I-gel compared with the classic laryngeal mask airway (cLMA) and ProSeal laryngeal mask airway (pLMA) in anaesthetized, paralysed patients. Methods The American Society of Anesthesiologists physical status I-II patients (n = 167) scheduled for orthopaedic surgery were included in this prospective study. General anaesthesia was achieved with intravenous infusion of propofol, remifentanil and rocuronium. The patients were randomly assigned to I-gel, pLMA and cLMA groups (64, 53 and 50 patients, respectively). Properly sized I-gel (No. 3-4) or LMA (No. 4-5) was inserted. We assessed haemodynamic data, airway leak pressure, leak volume, success rates and postoperative complications. Results There were no differences in the demographic data and haemodynamic data immediately after insertion of devices among the three groups. The airway leak pressures of the I-gel group (27.1 +/- 6.4 cmH(2)O) and pLMA group (29.8 +/- 5.7 cmH(2)O) were significantly higher than that of the cLMA group (24.7 +/- 6.2 cmH(2)O). The success rates for first attempt of insertion were similar among the three groups (P = 0.670). There were no differences in the incidence of adverse events except for the larger incidence of sore throat in the cLMA group. Conclusion I-gel may have a similar airway sealing to that of pLMA, higher than that of cLMA, and is not associated with adverse events. The I-gel might be an effective alternative as a supraglottic airway device. Eur J Anaesthesiol 2010;27:598-601