title: Tracheal intubation through the I-gel™ supraglottic airway versus the LMA Fastrach™: a randomized controlled trial.
abstract: BACKGROUND
  The i-gel™ is a supraglottic airway device not requiring inflation of a cuff for lung ventilation. Its design allows for unobstructed passage of a tracheal tube and previous studies have demonstrated a favorable alignment with the glottic inlet. In this prospective randomized study, we compared the success rate of blind tracheal intubation using the i-gel and the laryngeal mask airway (LMA) Fastrach™.
  
  
  METHODS
  One hundred sixty patients requiring general anesthesia and airway management were randomized to tracheal intubation using the i-gel or the LMA Fastrach. After induction of general anesthesia, the allocated device was inserted and adequate lung ventilation was confirmed. Blind tracheal intubation was then attempted. First attempt and overall tracheal intubation success rates were evaluated and tracheal intubation times were measured.
  
  
  RESULTS
  Eighty patients were recruited in each study group. Successful tracheal intubation was obtained on the first attempt in 69% of patients with the i-gel and 74% of patients with the LMA Fastrach (95% confidence interval [CI] of difference, -9% to 19%, P = 0.60). The overall intubation success rate was lower using the i-gel than it was using the LMA Fastrach (73% vs 91%, 95% CI of difference, 7% to 31%, P < 0.0001).
  
  
  CONCLUSIONS
  On first attempts, successful blind tracheal intubation was obtained at comparable rates using the i-gel and the LMA Fastrach. However, when the first attempt was unsuccessful, subsequent attempts through the i-gel did not significantly increase tracheal intubation success rate. The LMA Fastrach yielded a higher overall intubation success rate.
authors.affiliation: Department of Anesthesiology, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Quebec, Canada.
authors.forename: Antoine Elie
authors.initials: AE
authors.lastname: Halwagi
authors.forename: Nathalie
authors.initials: N
authors.lastname: Massicotte
authors.forename: Alexandre
authors.initials: A
authors.lastname: Lallo
authors.forename: Alain
authors.initials: A
authors.lastname: Gauthier
authors.forename: Daniel
authors.initials: D
authors.lastname: Boudreault
authors.forename: Monique
authors.initials: M
authors.lastname: Ruel
authors.forename: François
authors.initials: F
authors.lastname: Girard
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D016009:Chi-Square Distribution; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011792:Quebec; D012121:Respiration, Artificial / Q000009:adverse effects / Q000295:instrumentation*; D013997:Time Factors