title: A comparison of the i-gel and classic LMA insertion in manikins by experienced and novice physicians.
abstract: OBJECTIVE
  Airway management is of utmost importance in critical patients, for whom endotracheal intubation remains the gold standard. However, it is a difficult skill to acquire and success rates in novices are unacceptably low. Supraglottic devices constitute promising alternatives. The aim of this study was to assess the use of laryngeal mask airway (LMA) classic LMA (cLMA) and a relatively new supraglottic device, the i-gel, in experienced and novice doctors in a manikin setting.
  
  
  METHODS
  The study population comprised 116 doctors. After a brief educational session and presentation of cLMA and i-gel, participants were randomly allocated to insert both devices in an adult manikin. Insertions were performed using a size-4 cLMA and a size-4 i-gel. The primary endpoints were the success rate for each device and the duration of the insertion attempt. Secondary endpoint was the perception of ease of use with each device.
  
  
  RESULTS
  First attempt success rate was 90.5% for i-gel and 63.8% for cLMA (P<0.001). I-gel use reduced insertion times (13.32±4.99 s vs. 17.99±6.87 s, P<0.001) and was related with significantly higher first attempt success rates than cLMA in novices (90 vs. 48.3%, P<0.001). In addition, i-gel use provided almost equal success rates for experienced and novice doctors (91 vs. 90%, P=not significant), whereas cLMA use resulted in significantly lower success rates for novices (48.3 vs. 80.4%, P<0.001).
  
  
  CONCLUSIONS
  In this manikin setting i-gel significantly improved success rates and insertion time compared with cLMA. Most importantly, i-gel use resulted in high first pass success rates for novice doctors, equal to those achieved by experienced doctors.
authors: Anesthesiology Department, Metaxa Hospital of Piraeus, Piraeus, Greece.
authors: Konstantinos
authors: K
authors: Stroumpoulis
authors: Christina
authors: C
authors: Isaia
authors: Eleni
authors: E
authors: Bassiakou
authors: Ioannis
authors: I
authors: Pantazopoulos
authors: Georgios
authors: G
authors: Troupis
authors: Antonios
authors: A
authors: Mazarakis
authors: Theano
authors: T
authors: Demestiha
authors: Theodoros
authors: T
authors: Xanthos