Tracheal intubation with I-gel supraglottic device in pediatric patients: a prospective case series
Currently, there are no devices showing an acceptable success rate in blind intubation in pediatrics.
The purpose of this particular series of cases is to identify the percentage of successful blind intubations using the Igel laryngeal mask in children between 2 and 35 kg of body weight, in addition to evaluating seal pressure, fiber optics vision through the device, and reporting the occurrence of complications.
Materials and methods:
A prospective case series in pediatrics; patients from 2 to 35 kg.
According to our study, the overall percentage of blind intubation was 23%, while the percentages of ideal and low vision to facilitate the insertion of the bronchoscope into the airway, and then inserting a tracheal tube through the fiber optics was 70%.
We feel that the supraglottic I-gel is not the appropriate device for blind intubation; however, it is an acceptable recommendation to conduct fiber optics intubation.
2. Heinrich S1, Birkholz T, Ihmsen H. Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures. Paediatr Anaesth 2012;22:729-736.
3. Gasteiger L, Brimacombe J, Oswald E, et al. LMA ProSeal(TM) vs. i-Gel(TM) in ventilated children: a randomised, crossover study usingthe size 2 mask. Acta Anaesthesiol Scand 2012;56:1321-1324.
4. Theiler L, Kleine-Brueggeney M, Urwyler N, et al. Randomized clinical trial of the i-gel and Magill tracheal tube or single-use ILMA (and ILMA (tracheal tube for blind intubation in anaesthetized patients with a predicted difficult airway. Br J Anaesth 2011;107:243-250.
5. Theiler L, Gutzmann M, Kleine-Brueggeney M, et al. i-gel supraglottic airway in clinical practice: a prospective observational multicentre study. Br J Anaesth 2012;109: 990-995.
6. Duckett J, Fell P, Han K, et al. Introduction of the i-gel supraglottic airway device for prehospital airway management in a UK ambulance. Emerg Med J 2014;31:505-507.
7. Chauhan G, Nayar P, Seth A, et al. Comparison of clinical performance of the I-gel with LMA proseal. J Anaesthesiol Clin Pharmacol 2013;29:56-60.
8. Emmerich M, Tiesmeier J. The I-gel supraglottic airway: a useful tool in case of difficult fiberoptic intubation. Minerva Anestesiol 2012;78:1169-1170.
9. Michalek P, Hodgkinson P, Donaldson W. Fiberoptic intubation through an I-gel supraglottic airway in two patients with predicted difficult airway and intellectual disability. Anesth Analg 2008;106:1501-1504.
10. Michalek P, Donaldson W, Graham C, et al. A comparison of the Igel supraglottic airway as a conduit for tracheal intubation with the intubating laryngeal mask airway: a manikin study. Resuscitation 2010;81:74-77.
11. Sethi P, Samra T, Gupta N. Comparison of supraglottic devices i-gel((r)) and LMA Fastrach((r)) as conduit for endotracheal intubation. Indian J Anaesth 2014;58:790.
12. Cook TM, Cranshaw J. Randomized crossover comparison of ProSeal laryngeal mask airway with laryngeal tube sonda during anaesthesia with controlled ventilation. Br J Anaesth 2005;95:261-266.