title: Randomized trial comparing the i-gel™ and Magill tracheal tube with the single-use ILMA™ and ILMA™ tracheal tube for fibreoptic-guided intubation in anaesthetized patients with a predicted difficult airway.
abstract: BACKGROUND
  The i-gel™ is a single-use supraglottic airway device (SAD) that allows fibreoptic-guided tracheal intubation through the device. Until now, no prospective data for this procedure are available. Therefore, in a prospective randomized controlled trial, we evaluated fibreoptic-guided tracheal intubation with a standard Rüsch™ PVC tracheal tube (TT) through the i-gel™ compared with the single-use ILMA™ (sILMA™) TT through the sILMA™ in patients with a predicted difficult airway.
  
  
  METHODS
  With ethics committee approval and written informed consent, 160 patients were randomly assigned to either SAD. After placement of the SAD, a fibreoptic bronchoscope was introduced into the trachea as a railroad for the TT. Primary outcome variable was the first-attempt fibreoptic-guided intubation success rate. Secondary variables included time for insertion and intubation, airway leak pressures, fibreoptic view, and adverse events. Data are presented as mean (sd) or percentages. A P-value of < 0.05 was considered statistically significant.
  
  
  RESULTS
  Fibreoptic-guided intubation was successful at the first attempt in 76 patients (96%) using the i-gel™ and in 71 patients (90%) using the sILMA™ (P=0.21). Most of the failed intubations were rescued by conventional laryngoscopy. Airway leak pressure was higher for the sILMA™. There were no problems during removal of either type of SAD.
  
  
  CONCLUSIONS
  Fibreopic-guided tracheal intubation through the i-gel™ using a standard Rüsch™ Magill TT is successful and an alternative to the sILMA™ with the sILMA™ TT.
authors.affiliation: Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital Bern, and University of Bern, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Kleine-Brueggeney
authors.forename: L
authors.initials: L
authors.lastname: Theiler
authors.forename: N
authors.initials: N
authors.lastname: Urwyler
authors.forename: A
authors.initials: A
authors.lastname: Vogt
authors.forename: R
authors.initials: R
authors.lastname: Greif
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods; D020878:Device Removal; D004209:Disposable Equipment; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D016037:Single-Blind Method; D055815:Young Adult