title: Challenge to pediatric anatomical variation : Can we draw the ideal line on the pediatric I-gel?
abstract: OBJECTIVE
  I-gel is a noncuff type of laryngeal airway mask. No horizontal line has yet been determined as an ideal position for pediatric sizes because of the variability in length of the oropharyngeal-laryngeal arch in children. We investigated whether there is a correlation between insertion length and patient body weight or height for the pediatric I-gel sizes from 1.5 to 2.5.
  
  
  METHODS
  With parental informed consent, we planned to maintain the airway of 130 children aged from 7 months to 13 years by using the I-gel device under general anesthesia. The following two parameters were evaluated: (1) distance between the teeth and the connector wing; (2) insertion length (distance from the distal end of the gastric tube to the teeth). Size selection was determined on the basis of patients' body weight. We identified the relationship between each parameter and height or weight.
  
  
  RESULTS
  Average insertion length became gradually longer with increasing height and weight. Spearman's R between insertion length and height or weight was 0.8. There was more correlation with height than with weight in pediatric size 2.5.
  
  
  CONCLUSIONS
  Results suggested that it is possible to draw an ideal line on the I-gel with sizes 1.5 and 2 only.
authors.affiliation: Department of Anesthesia and Critical Care, Tokyo Women's, Medical University, 8-1 Kawadachou Shinjyuku-ku, Tokyo, 162-8666, Japan. yukako1@rg8.so-net.ne.jp.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Abukawa
authors.affiliation: Department of Anesthesia and Critical Care, Tokyo Women's, Medical University, 8-1 Kawadachou Shinjyuku-ku, Tokyo, 162-8666, Japan.|Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa, 232-8555, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hiroki
authors.affiliation: Department of Anesthesia and Critical Care, Tokyo Women's, Medical University, 8-1 Kawadachou Shinjyuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Iwakiri
authors.affiliation: Department of Anesthesia and Critical Care, Tokyo Women's, Medical University, 8-1 Kawadachou Shinjyuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Fukada
authors.affiliation: Department of Anesthesia and Critical Care, Tokyo Women's, Medical University, 8-1 Kawadachou Shinjyuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ozaki
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General / Q000379:methods*; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D017214:Laryngeal Masks; D007830:Larynx / Q000033:anatomy & histology*; D008297:Male
keywords: Anatomical variability; I-gel; Laryngeal mask; Pediatric