title: Prewarming of the i-gel facilitates successful insertion and ventilation efficacy with muscle relaxation: a randomized study.
abstract: OBJECTIVE
  To determine if prewarming of the i-gel (Intersurgical, Wokingham, United Kingdom) improves insertion and ventilation efficacy with muscle relaxation in patients undergoing elective surgery.
  
  
  METHODS
  Clinical randomized study.
  
  
  METHODS
  Operating room.
  
  
  METHODS
  Sixty-eight adult patients scheduled for elective surgery under general anesthesia with American Society of Anesthesiologists physical status 1-3.
  
  
  METHODS
  The i-gel was warmed to 42°C for 30 minutes before insertion (W group; 34 patients) or kept at room temperature (approximately 23°C) (C group; 34 patients).
  
  
  METHODS
  The number of attempts for a successful insertion and the sealing pressure and leak volume 30 seconds and 30 minutes after initiating mechanical ventilation.
  
  
  RESULTS
  The total insertion attempts were 1 (W group, 31 cases; C group, 24 cases) and 2 (W group, 3 cases; C group, 10 cases), which was significant (P = .001). Sealing pressure was significantly higher in the W group than the C group (W group, 21.8 ± 3.7 cm H2O; C group, 18.5 ± 3.4 cm H2O; P = .001). Leak volume was significantly smaller after 30 seconds in the W group than the C group (P = .002), but not after 30 minutes (P = .69).
  
  
  CONCLUSIONS
  Prewarming the i-gel to 42°C demonstrated a higher successful ventilation initiation.
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan. Electronic address: ane078@poh.osaka-med.ac.jp.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Komasawa
authors.affiliation: Department of Anesthesiology, Hokusetsu General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Nishihara
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Tatsumi
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Minami
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009126:Muscle Relaxation / Q000502:physiology; D011312:Pressure; D012121:Respiration, Artificial / Q000379:methods*; D013696:Temperature
keywords: Leakage volume; Pre-warming; Sealing pressure; i-gel