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The i-gel Supraglottic Airway as a Conduit for Fibreoptic Tracheal Intubation - A Randomized Comparison with the Single-use Intubating Laryngeal Mask Airway and CTrach Laryngeal Mask in Patients with Predicted Difficult Laryngoscopy.
Prague Med Rep. 2016; 117(4):164-175.PM

Abstract

Fibreoptic intubation through a supraglottic airway is an alternative plan for airway management in difficult or failed laryngoscopy. The aim of this study was to compare three supraglottic airways as conduits in patients with at least one predictor for difficult laryngoscopy. The i-gel was compared with the single-use intubating laryngeal mask airway (sILMA) and CTrach laryngeal mask in 120 adult patients scheduled for elective surgeries under general anaesthesia using a prospective, randomized and single-blinded design. Primary outcome was success rate of tracheal intubation through the device, while secondary outcomes were times required for device insertion and tracheal tube placement, fibreoptic scores and the incidence of perioperative complications and postoperative complaints. The success rates showed no statistical difference between devices (i-gel 100%, CTrach 97.5%, ILMA 95%). Insertion time was shortest for the i-gel (12.4 s) compared with ILMA (19.3 s) and CTrach (24.4 s). Intubation time was shorter in the i-gel group (29.4 s) in comparison with the CTrach (39.8 s, p<0.05) and sILMA (51.9 s, p<0.001) groups. Best fibreoptic scores were observed also in the i-gel group. In total, 24 patients (20%) presented with difficult laryngoscopy. The i-gel showed significantly shorter times for insertion and fibreoptic intubation than the other two devices in this group. No difference was observed in the incidence of postoperative complaints. The i-gel is a suitable alternative to the sILMA and CTrach for fibrescope-guided tracheal intubation. Shorter insertion and intubation times with the i-gel may provide advantage in case of difficult oxygenation.

Authors+Show Affiliations

Department of Anaesthetics, Antrim Area Hospital, Northern HSC Trust, Antrim, United Kingdom. pavel.michalek@vfn.cz. Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic. pavel.michalek@vfn.cz.Department of Anaesthetics, Antrim Area Hospital, Northern HSC Trust, Antrim, United Kingdom.Department of Anaesthetics, Antrim Area Hospital, Northern HSC Trust, Antrim, United Kingdom.Department of Anaesthetics, Antrim Area Hospital, Northern HSC Trust, Antrim, United Kingdom.Department of Anaesthesia, Daisy Hill Hospital, Southern HSC Trust, Newry, United Kingdom.AstraZeneca, Washington D.C., USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27930894

Citation

Michálek, Pavel, et al. "The I-gel Supraglottic Airway as a Conduit for Fibreoptic Tracheal Intubation - a Randomized Comparison With the Single-use Intubating Laryngeal Mask Airway and CTrach Laryngeal Mask in Patients With Predicted Difficult Laryngoscopy." Prague Medical Report, vol. 117, no. 4, 2016, pp. 164-175.
Michálek P, Donaldson W, McAleavey F, et al. The i-gel Supraglottic Airway as a Conduit for Fibreoptic Tracheal Intubation - A Randomized Comparison with the Single-use Intubating Laryngeal Mask Airway and CTrach Laryngeal Mask in Patients with Predicted Difficult Laryngoscopy. Prague Med Rep. 2016;117(4):164-175.
Michálek, P., Donaldson, W., McAleavey, F., Abraham, A., Mathers, R. J., & Telford, C. (2016). The i-gel Supraglottic Airway as a Conduit for Fibreoptic Tracheal Intubation - A Randomized Comparison with the Single-use Intubating Laryngeal Mask Airway and CTrach Laryngeal Mask in Patients with Predicted Difficult Laryngoscopy. Prague Medical Report, 117(4), 164-175. https://doi.org/10.14712/23362936.2016.17
Michálek P, et al. The I-gel Supraglottic Airway as a Conduit for Fibreoptic Tracheal Intubation - a Randomized Comparison With the Single-use Intubating Laryngeal Mask Airway and CTrach Laryngeal Mask in Patients With Predicted Difficult Laryngoscopy. Prague Med Rep. 2016;117(4):164-175. PubMed PMID: 27930894.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The i-gel Supraglottic Airway as a Conduit for Fibreoptic Tracheal Intubation - A Randomized Comparison with the Single-use Intubating Laryngeal Mask Airway and CTrach Laryngeal Mask in Patients with Predicted Difficult Laryngoscopy. AU - Michálek,Pavel, AU - Donaldson,Will, AU - McAleavey,Francis, AU - Abraham,Alexander, AU - Mathers,Rachel J, AU - Telford,Claire, PY - 2016/12/9/entrez PY - 2016/12/9/pubmed PY - 2017/6/7/medline KW - CTrach KW - Fibreoptic intubation KW - Intubating laryngeal mask airway KW - i-gel SP - 164 EP - 175 JF - Prague medical report JO - Prague Med Rep VL - 117 IS - 4 N2 - Fibreoptic intubation through a supraglottic airway is an alternative plan for airway management in difficult or failed laryngoscopy. The aim of this study was to compare three supraglottic airways as conduits in patients with at least one predictor for difficult laryngoscopy. The i-gel was compared with the single-use intubating laryngeal mask airway (sILMA) and CTrach laryngeal mask in 120 adult patients scheduled for elective surgeries under general anaesthesia using a prospective, randomized and single-blinded design. Primary outcome was success rate of tracheal intubation through the device, while secondary outcomes were times required for device insertion and tracheal tube placement, fibreoptic scores and the incidence of perioperative complications and postoperative complaints. The success rates showed no statistical difference between devices (i-gel 100%, CTrach 97.5%, ILMA 95%). Insertion time was shortest for the i-gel (12.4 s) compared with ILMA (19.3 s) and CTrach (24.4 s). Intubation time was shorter in the i-gel group (29.4 s) in comparison with the CTrach (39.8 s, p<0.05) and sILMA (51.9 s, p<0.001) groups. Best fibreoptic scores were observed also in the i-gel group. In total, 24 patients (20%) presented with difficult laryngoscopy. The i-gel showed significantly shorter times for insertion and fibreoptic intubation than the other two devices in this group. No difference was observed in the incidence of postoperative complaints. The i-gel is a suitable alternative to the sILMA and CTrach for fibrescope-guided tracheal intubation. Shorter insertion and intubation times with the i-gel may provide advantage in case of difficult oxygenation. SN - 1214-6994 UR - https://www.unboundmedicine.com/medline/citation/27930894/The_i_gel_Supraglottic_Airway_as_a_Conduit_for_Fibreoptic_Tracheal_Intubation___A_Randomized_Comparison_with_the_Single_use_Intubating_Laryngeal_Mask_Airway_and_CTrach_Laryngeal_Mask_in_Patients_with_Predicted_Difficult_Laryngoscopy_ L2 - https://pmr.lf1.cuni.cz/fulltext/?doi=10.14712/23362936.2016.17 DB - PRIME DP - Unbound Medicine ER -