Comparison of a Supraglottic Gel Device and an Endotracheal Tube in Keratoplasty Performed Under General Anesthesia: A Randomized Clinical Trial.
OBJECTIVE
To assess the safety of a laryngeal mask (i-gel) in keratoplasty performed under general anesthesia.


METHODS
Patients with indications for keratoplasty (n = 110) were enrolled in a prospective study and randomly assigned to the i-gel (n = 55; 30 lamellar keratoplasty and 25 penetrating keratoplasty) or tracheal tube group (n = 55; 29 lamellar keratoplasty and 26 penetrating keratoplasty). Perioperative complications and the recovery time were compared between the 2 groups using the t test or χ(2) test. Contraindications to elective use of the laryngeal mask airway (esophageal reflux, extreme obesity, oropharyngeal pathology, or expected difficult intubation) and expected difficult intubation were excluded.


RESULTS
No surgical perioperative complications were reported in either group. There was a significantly greater incidence of coughing at extubation and/or after extubation in the tracheal group (40/55; 73%) than in the laryngeal mask group (3/55; 5%) (P < 0.001). The recovery time was shorter in the i-gel group (80 minutes; 95% confidence interval, 75-86) compared with that in the tracheal tube group (88 minutes; 95% confidence interval, 82-95) (P = 0.03). There were no significant differences in the incidence of sore throat and hoarseness between both devices.


CONCLUSIONS
The use of i-gel for keratoplasty under general anesthesia appears to be safe, reduces the risk of potential ocular hypertension during recovery, and saves recovery time.
*Service d'Anesthésie-Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France; and †Service d'Ophtalmologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
Gilles
G
Guerrier
David
D
Boutboul
Sylvie
S
Rondet
Dalila
D
Hallal
Jacques
J
Levy
Lea
L
Sjögren
Jean-Marc
JM
Legeais
Romain
R
Nicolau
Chadi
C
Mehanna
Jean-Louis
JL
Bourges
Charles Marc
CM
Samama
D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D003316:Corneal Diseases / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies