title: I-gel as an alternative to endotracheal tube in adult laparoscopic surgeries: A comparative study.
abstract: BACKGROUND
  The tracheal tube is always considered to be the gold standard for laparoscopic surgeries. As conventional laryngoscopy guided endotracheal intubation evokes significant hypertension and tachycardia, we have used I-gel, second generation extraglottic airway device, in an attempt to overcome these drawbacks. We conducted this study to compare haemodynamic changes during insertion, efficacy of ventilation, and complications with the use of I-gel when compared with endotracheal tube (ETT) in laparoscopic surgeries.
  
  
  METHODS
  A total of 60 American Society of Anaesthesiologists physical status I and II adult patients undergoing elective laparoscopic surgeries were randomly allocated to one of the two groups of 30 patients each: Group-A (I-gel) in which patients airway was secured with appropriate sized I-gel, and Group-B (ETT) in which patients airway was secured with laryngoscopy - guided endotracheal intubation. Ease, attempts and time for insertion of airway device, haemodynamic and ventilatory parameters at different time intervals, and attempts for gastric tube insertion, and perioperative complications were recorded.
  
  
  RESULTS
  There was significant rise in pulse rate and mean blood pressure during insertion with use of ETT when compared to I-gel. Furthermore, time required for I-gel insertion was significantly less when compared with ETT. However ease and attempts for airway device insertion, attempts for gastric tube insertion and efficacy of ventilation were comparable between two groups.
  
  
  CONCLUSIONS
  We concluded that I-gel requires less time for insertion with minimal haemodynamic changes when compared to ETT. I-gel also provides adequate positive-pressure ventilation, comparable with ETT. Hence I-gel can be a safe and suitable alternative to ETT for laparoscopic surgeries.
authors.affiliation: Department of Anaesthesiology, Pandit Deendayal Upadhyay Medical College (PDUMC), Rajkot, Gujarat, India.
authors.forename: Jigisha Prahladrai
authors.initials: JP
authors.lastname: Badheka
authors.affiliation: Department of Anaesthesiology, Pandit Deendayal Upadhyay Medical College (PDUMC), Rajkot, Gujarat, India.
authors.forename: Rashida Mohammedi
authors.initials: RM
authors.lastname: Jadliwala
authors.affiliation: Department of Anaesthesiology, Pandit Deendayal Upadhyay Medical College (PDUMC), Rajkot, Gujarat, India.
authors.forename: Vrajeshchandra Amrishbhi
authors.initials: VA
authors.lastname: Chhaya
authors.affiliation: Department of Anaesthesiology, Pandit Deendayal Upadhyay Medical College (PDUMC), Rajkot, Gujarat, India.
authors.forename: Vandana Surendrabhai
authors.initials: VS
authors.lastname: Parmar
authors.affiliation: Department of Anaesthesiology, Pandit Deendayal Upadhyay Medical College (PDUMC), Rajkot, Gujarat, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Vasani
authors.affiliation: Department of Surgery, Pandit Deendayal Upadhyay Medical College (PDUMC), Rajkot, Gujarat, India.
authors.forename: Ajay Maganlal
authors.initials: AM
authors.lastname: Rajyaguru
keywords: Endotracheal intubation; I-gel; hemodynamic parameters; laparoscopic surgery; positive-pressure ventilation