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.
Key
Words
Ventilation:
I-Gel supraglottic airway.
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
-
Gabbott DA,
Beringer R. The iGEL supraglottic airway: a potential role for
resuscitation (correspondence)?
Resuscitation 73:161-162, 2007.
-
Levitan RM,
Kinkle WC. Initial anatomic investigations of the I-gel airway: a novel
supraglottic airway without inflatable cuff.
Anaesthesia 60:1022-1026, 2005.
-
Soar J. The
i-gel supraglottic airway and resuscitation - some initial thoughts (correspondence).
Resuscitation 74:197, 2007.