Internet Journal of Airway Management

 

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Volume 4 (January 2006 to December 2007)


 

The Disposable I-Gel Supraglottic Airway with an Esophageal Vent

 

 

Ernst Zadrobilek, MD1

 

1Associate Professor of Anesthesia and Intensive Care, Chairman of the Austrian Working Group for Airway Management and Director of the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.

 

Address correspondence and comments to Ernst Zadrobilek.

 

Received from the Department of Anesthesia and Intensive Care, Empress Elisabeth Hospital of the City of Vienna, Vienna, Austria.

 

Published: December 1, 2007.

 


 

The correct citation of this communiction of new equipment and techniques is:

Zadrobilek E. The disposable I-Gel supraglottic airway with an esophageal vent. Internet Journal of Airway Management 4, 2006-2007.
Available from URL:
http://www.adair.at/ijam/volume04/newequipment04/default.htm
Date accessed: month day, year.

 


Last updated: December 1, 2007.


 

Intersurgical (Wokingham, United Kingdom) recently released a new disposable supraglottic airway device (made of a medical-grade thermoplastic elastomer) with an anatomically designed noninflatable mask, a drain tube serving as an esophageal vent, and an integrated bite block, marketed under I-Gel (IG). The IG is packaged sterile within a color-coded plastic cage and currently available in three sizes (sizes 3 to 5, recommended by the manufacturer for use in small, medium, and large adults, respectively). The mask of the IG is made from an unique soft gel-like material allowing ease of insertion and reduced trauma; the drain tube is placed at the right side of the airway tube and ends at the distal tip of the mask. When the appropriate size is used and the airway is correctly placed in the hypopharynx, the opening of the mask should be accurately positioned over the laryngeal aperture providing a reliable perilaryngeal seal.

 

Levitan and Kinkle (2) performed anatomical investigations with the IG in human cadavers. They found, that the IG effectively conformed to the perilaryngeal anatomy and consistently achieved proper positioning for supraglottic ventilation; using a malleable fiberoptic stylet, a full view of the laryngeal aperture through the airway tube was achieved in 60 percent (44/73 insertions) and in only 4 percent, visualization of laryngeal structures could not be obtained.

 

A supraglottic airway without an inflatable, but sealing mask, and with an esophageal vent may have several potential advantages as airway with ready availability, easy insertion, and reliable ventilation particularly during resuscitation. Gabott and Beringer (1) evaluated the IG in 100 patients requiring ventilation during general anesthesia for minor surgical procedures; in 98 percent, the IG was adequately positioned at the first or second attempt. Soar (3), having personal experiences with the IG in anesthetic practice, would also support the use of this airway device for rescue ventilation during resuscitation. Unfortunately, there are currently no studies on the performance and efficiency of the IG in this patient population.

 

The costs of the IG are about 10 Euro (exclusive value-added taxes, according to the offer of the Austrian distributor, queried in December 2007).

 

 

References

  1. Gabbott DA, Beringer R. The iGEL supraglottic airway: a potential role for resuscitation (correspondence)? Resuscitation 73:161-162, 2007.

  2. Levitan RM, Kinkle WC. Initial anatomic investigations of the I-gel airway: a novel supraglottic airway without inflatable cuff. Anaesthesia 60:1022-1026, 2005.

  3. Soar J. The i-gel supraglottic airway and resuscitation - some initial thoughts (correspondence). Resuscitation 74:197, 2007. 


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