title: Comparison of the i-gel and other supraglottic airways in adult manikin studies: Systematic review and meta-analysis.
abstract: BACKGROUND
  The i-gel has a gel-like cuff composed of thermoplastic elastomer that does not require cuff inflation. As the elimination of cuff inflation may shorten insertion time, the i-gel might be a useful tool in emergency situations requiring prompt airway care. This systematic review and meta-analysis of previous adult manikin studies for inexperienced personnel was performed to compare the i-gel with other supraglottic airways.
  
  
  METHODS
  We searched PubMed, the Cochrane Library, and EMBASE for eligible randomized controlled trials (RCTs) published before June 2015, including with a crossover design, using the following search terms: "i-gel," "igel," "simulation," "manikin," "manikins," "mannequin," and "mannequins." The primary outcomes of this review were device insertion time and the first-attempt success rate of insertion.
  
  
  RESULTS
  A total of 14 RCTs were included. At the initial assessment without difficult circumstances, the i-gel had a significantly shorter insertion time than the LMA Classic, LMA Fastrach, LMA Proseal, LMA Unique, laryngeal tube, Combitube, and EasyTube. However, a faster insertion time of the i-gel was not observed in comparisons with the LMA Supreme, aura-i, and air-Q. In addition, the i-gel did not show the better results for the insertion success rate when compared to other devices.
  
  
  CONCLUSIONS
  The findings of this meta-analysis indicated that inexperienced volunteers placed the i-gel more rapidly than other supraglottic airways with the exception of the LMA Supreme, aura-i, and air-Q in manikin studies. However, the quicker insertion time is clinically not relevant. The unapparent advantage regarding the insertion success rate and the inherent limitations of the simulation setting indicated that additional evidence is necessary to confirm these advantages of the i-gel in an emergency setting.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jiwon
authors.initials: J
authors.lastname: An
authors.forename: Sang Beom
authors.initials: SB
authors.lastname: Nam
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Jinae
authors.initials: J
authors.lastname: Lee
authors.forename: Hanna
authors.initials: H
authors.lastname: Yoo
authors.forename: Hye Mi
authors.initials: HM
authors.lastname: Lee
authors.forename: Min-Soo
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000328:Adult; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D006801:Humans; D017214:Laryngeal Masks; D008348:Manikins