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British Journal of Anaesthesia 2009 102(2):264-268; doi:10.1093/bja/aen366
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2009. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

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

V. Uppal1,*, G. Fletcher2 and J. Kinsella1

1 Section of Anaesthesia, Pain and Critical Care, Faculty of Medicine, University of Glasgow, Glasgow, UK
2 Department of Anaesthesia, Royal Alexandra Hospital, Paisley, UK

* Corresponding author: Section of Anaesthesia, Pain and Critical Care, Faculty of Medicine, University of Glasgow, Level 2, QEB Glasgow Royal Infirmary, Glasgow G31 2ER, UK. E-mail: drvishal76{at}rediffmail.com

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 (P=0.014) and the median difference in leak volume was 26.5 ml (P=0.006). 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.

Keywords: equipment, airway; ventilation, mechanical


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Home page
 Br J AnaesthHome page
V. Uppal, S. Gangaiah, G. Fletcher, and J. Kinsella
Randomized crossover comparison between the i-gel and the LMA-Unique in anaesthetized, paralysed adults
Br. J. Anaesth., December 1, 2009; 103(6): 882 - 885.
[Abstract] [Full Text] [PDF]

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Unsatisfactory performance of supraglottic airway devices
John J Henderson
British Journal of Anaesthesia, 1 Apr 2009 [Full text]
In Reply
Vishal Uppal, et al.
British Journal of Anaesthesia, 16 Apr 2009 [Full text]

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