A comparison of the I-gel supraglottic airway as a conduit for tracheal intubation with the intubating laryngeal mask airway: a manikin study.
BACKGROUND
Insertion of a supraglottic airway and tracheal intubation through it may be indicated in resuscitation scenarios where conventional laryngoscopy fails. Various supraglottic devices have been used as conduits for tracheal intubation, including the intubating laryngeal mask airway (ILMA), the Ctrach laryngeal mask and the I-gel supraglottic airway.


METHODS
A prospective study with 25 participants evaluated the success rate of blind intubation (using a gum-elastic bougie, an Aintree intubating catheter (AIC) and designated tracheal tube) and fibrescope-guided tracheal intubation (through the intubating laryngeal mask airway and the I-gel supraglottic airway) on three different airway manikins.


RESULTS
Twenty-five anaesthetists performed three intubations with each method on each of three manikins. The success rate of the fibrescope-guided technique was significantly higher than blind attempts (P<0.0001) with both devices. For fibreoptic techniques, there was no difference found between the ILMA and I-gel (P>0.05). All blind techniques were significantly more successful in the ILMA group compared to the I-gel (P<0.0001 for bougie, Aintree catheter and tracheal tube, respectively).


CONCLUSIONS
The results of this study show that, in manikins, fibreoptic intubation through both ILMA and I-gel is a highly successful technique. Blind intubation through the I-gel showed a low success rate and should not be attempted.
Michalek
P
P
Department of Anaesthesia, Antrim Area Hospital, Antrim, United Kingdom. pafkamich@yahoo.co.uk
Donaldson
W
W
Graham
C
C
Hinds
J D
JD
D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000295:instrumentation*; D016009:Chi-Square Distribution; D004635:Emergency Medicine / Q000193:education; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D017214:Laryngeal Masks; D020704:Laryngoscopes; D008348:Manikins; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014827:Vocal Cords