Comparison of the i-gel with the cuffed tracheal tube during pressure-controlled ventilation

Uppal, V., Fletcher, G. and Kinsella, J. (2009) Comparison of the i-gel with the cuffed tracheal tube during pressure-controlled ventilation. British Journal of Anaesthesia, 102(2), pp. 264-268. (doi: 10.1093/bja/aen366)

Abstract

Background. The i-gel (Intersurgical Ltd) is a novel device that differs from other supraglottic airway devices in that it has a softer and a non-inflatable cuff. Our study was designed to assess whether the i-gel is suitable to provide pressure-controlled ventilation (PCV) during anaesthesia by measuring the gas leaks and comparing these values with that of the tracheal tube. Methods. Twenty-five patients, ASA I–II, were recruited to the study. Patients received a standard anaesthetic technique followed by an initial placement of the i-gel. The lungs were then ventilated at three different pressures (15, 20, 25 cm H2O) using PCV. The difference between the inspired and expired tidal volumes was used to calculate the leak volume. The leak fraction was defined as the leak volume divided by the inspired tidal volume. Following these observations, the i-gel was removed and replaced with the conventional tracheal tube and the recordings repeated. Results. There was no significant difference between the leak fractions of the i-gel and the tracheal tube at 15 and 20 cm H2O PCV. At 25 cm H2O, the median difference in leak fraction was 0.02 (P¼0.014) and the median difference in leak volume was 26.5 ml (P¼0.006). There was no evidence of gastric insufflations with any of the pressures used during PCV. Conclusions. We suggest that the i-gel can be used as a reasonable alternative to tracheal tube during PCV with moderate airway pressures. Br J Anaesth 2009; 102: 264–8 Keywords: equipment, airway; ventilation, mechanical Accepted for publication: November 4, 2008

• Item Type: Articles
• Additional Information: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in British Journal of Anaesthesia following peer review. The definitive publisher-authenticated version Uppal, V. and Fletcher, G. and Kinsella, J. (2009) Comparison of the i-gel with the cuffed tracheal tube during pressure-controlled ventilation. British Journal of Anaesthesia, 102 (2). 264-268. is available online at: http://dx.doi.org/10.1093/bja/aen366
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Kinsella, Professor John
• Authors: Uppal, V., Fletcher, G., and Kinsella, J.
• Subjects: R Medicine > R Medicine (General); R Medicine > RC Internal medicine
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Journal Name: British Journal of Anaesthesia
• Publisher: Oxford University Press
• ISSN: 0007-0912
• Copyright Holders: Copyright © 2009 Oxford University Press
• First Published: First published in British Journal of Anaesthesia 102 (2): 264–268
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher.