i-gel™ in Ambulatory Surgery: A Comparison with LMA-ProSeal™ in Paralyzed Anaesthetized Patients.
BACKGROUND
Supraglottic devices have mostly eliminated the need of hemodynamically stressful routine endotracheal intubation for ambulatory surgeries. We aimed to compare hemodynamics- like blood pressure (BP) and heart rate (HR) alterations caused by stress response due to i-gel™ and LMA-ProSeal™ usage in Day care surgeries. Secondary outcomes included ease of insertion, time and number of attempts for the placement of devices.


METHODS
From April 2008 to July 2009, Sixty adult ASA I-II patients of either sex, aged 20-30, were randomly allocated into two groups (Group i-gel (n=30) receiving i-gel and Group PLMA (n=30) receiving LMA-ProSeal for airway maintenance) undergoing day care surgical procedures under general anaesthesia (GA).The ease of insertion and time taken for placement of device, postoperative complications were assessed. Haemodynamic parameters (HR, BP) were noted. It was a prospective, double blinded, and randomized controlled study. Parametric data were analyzed with the unpaired t-test and non-parametric data were analyzed with the Chi-square test. Unless otherwise stated, data are presented as mean (+ SD). p <0.05 was considered statistically significant.


RESULTS
Demographically both the groups were similar. i-gel was more easily inserted than LMA-ProSeal (90% vs. 83.33% respectively). i-gel insertion time was shorter than PLMA (14.9 vs. 20.0 sec respectively) and was statistically significant. Hemodynamics (HR, BP) were less altered in i-gel than PLMA and the results were statistically significant (p <0.05).


CONCLUSIONS
i-Gel; a relatively newer and cheap supraglottic device; insertion is easier and quicker as well as hemodynamically less stressful when compared with LMA-ProSeal in a day care setting.
Assitant Professor, Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital , Kolkata, India .
Anjan
A
Das
Assitant Professor, Department of Anaesthesiology, NRS Medical College , Kolkata, India .
Saikat
S
Majumdar
R.M.O. Cum Clinical Tutor, Department of Anaesthesiology, NRS Medical College , Kolkata, India .
Anindya
A
Mukherjee
R.M.O. Cum Clinical Tutor, Department of Anaesthesiology, Bangur Institute of Neurology , Kolkata, India .
Tapobrata
T
Mitra
R.M.O. Cum Clinical Tutor, Department of Anaesthesiology, I.P.G.M.E.R , Kolkata, India .
Ratul
R
Kundu
Associate Professor, Department of Anaesthesiology, NRS Medical College , Kolkata, India .
Bimal Kumar
BK
Hajra
Associate Professor, Department of Anaesthesiology, NRS Medical College , Kolkata, India .
Dipankar
D
Mukherjee
Professor and Ex- HOD, Department of Anaesthesiology, NRS Medical College , Kolkata, India .
Bibhukalyani
B
Das
ASA (American Society of Anaesthesiologists); Ambulatory (day care surgery); Blood pressure (BP) and Heart rate (HR); LMA—ProSeal™ (PLMA); i-gel™ (i-gel)