i-gel – News & Events

i-gel was showcased at the recent SFAR (Societe Francaise d’Anesthesie et de Reanimation) conference in Paris. A team of 12 individuals from Intersurgical were in attendance. The stand was inundated with delegates, as you can see by the picture, eager to take a look at the i-gel and see it in action on a mannikin. The inventor of the i-gel, Dr. Mohammed Nasir, was in attendance and was happy to answer questions about the product. Take a look at the events calendar to see where you can see i-gel in the future.

The correspondence section of the September edition of ‘Anaesthesia’, includes a letter from three anaesthetists at the Royal United Hospital Bath, UK, describing successful airway rescue with an i-gel in a case of failed ventilation and predicted difficult intubation, after two other well known competitor brands of supraglottic airway had failed.

The patient, a middle-aged obese female, scheduled for an elective hand operation, had a Mallampati score of 3 and mouth opening of 3cm. Following induction of anaesthesia, facemask ventilation with an oropharyngeal airway was found to be extremely difficult and oxygenation saturation fell rapidly. Two other well known brands of supraglottic airway were initially tried, but although insertion with both was performed easily, ventilation was not possible with either device. Rescue facemask ventilation again proved difficult and a size 4 i-gel was easily inserted. i-gel, ‘immediately provided unobstructed ventilation and stable oxygen saturation  of 98%’. IPPV produced ‘good ventilation and peak airway pressures of 25cm H2O for the remainder of the case’.

The authors comment on the potential role of the device in airway rescue where other more established supraglottic airway devices have failed. They also report that discussion with colleagues revealed that two other anaesthetists had also experienced cases where i-gel had been used successfully after the failure of other supraglottic airways. They concluded that, ‘the i-gel’s role in difficult airway management remains to be established’, but certain features of the device make it a, ‘potentially useful airway device in cases of difficult mask ventilation’. The complete correspondence can be obtained from the following link; http://www3.interscience.wiley.com/journal/121371462/abstract

This years Society of Airway Management Scientific meeting will be held in Boston between the 19th-21st September. Although the primary focus this year is on videolaryngoscopes and fibreoptic stylets, there is a Hands-On Workshop scheduled on supraglottic airways, which will include i-gel, run by Carin Hagberg and Daniel Cook. The full programme for the meeting can be downloaded from the SAM web-site at http://sam.zorebo.com/

Interim results of a study conducted at the Royal United Hospital in Bath were presented at the Difficult Airway Society Annual Meeting in Portsmouth last year. The completed study, entitled, ‘Evaluation of the size 4 i-gel airway in one hundred non-paralysed patients’, has just been published in Anaesthesia. The objective of the study was to assess the ‘ ease of use of the device, the quality of the airway achieved and any associated complications.’ The results were described as ‘very encouraging’ and in the discussion section, the authors commented that, ‘The i-gel was successfully inserted in all patients and allowed effective controlled ventilation in 98%. Rates of failure, manipulations required and complications were very low compared to other devices we have studied with similar methodology’. The complete study can be downloaded from this location

We’ve just added two new video clips, one shows pre-insertion preparation and the other is an overview on using the gastric channel. We hope you enjoy the clips and if you would like to know more or require the full video as a training resource then please contact us using the ‘Quick Enquiry’ form on the home page.

A new study from Bath and Gloucester in the UK evaluated the performance of i-gel in manikins and anaesthetised patients when used by novices. The i-gel was deployed with minimal evidence of patient trauma and 100% insertion success.

The authors summarised the results: ‘i-gel is rapidly inserted in both manikins and patients by novice users and compares favourably to other supraglottic airways available. Further work determining safety and efficacy during cardio-pulmonary resuscitation is required’
http://www.ncbi.nlm.nih.gov/pubmed/18557971

Three anaesthetists from the Central Manchester University Hospital in the UK report on the results of an evaluation they conducted on i-gel in 300 patients. The letter, published this month in the European Journal of Anaesthesiology, confirms first time insertion with i-gel was achieved in <5 seconds in 290 of the 300 patients. Three patients with difficult airway underwent  successful fibreoptic endotracheal intubation through i-gel and all patients underwent adequate pressure mode ventilation with airway pressures of 10-30cm H2O initially and  spontaneous breathing subsequently. In addition, lubricated gastric tubes were easily inserted through the gastric channel at the first attempt in all 80 cases where this was performed. A very interesting letter on a significant number of patients.
http://www.ncbi.nlm.nih.gov/pubmed/18534042

Ref: Evaluation of the i-gel airway in 300 patients. European Journal of Anaesthesiology 2008;1-2. Jun 6:1-2.

A letter published in the July edition Anaesthesia, entitled ‘Aspiration recognition with an i-gel airway’, (link to the abstract here) submitted by Liew, John and Ahmed from Nevill Hall Hospital in Gwent,  reports on a the case of a young male patient undergoing surgery where i-gel helped with the recognition and management of regurgitation.

During the case, gastric contents were noticed to be coming out of the gastric channel. No secretions were evident in the airway channel. As regurgitation continued, surgery was paused and and the patients airway secured following rapid sequence induction. ‘Laryngoscopy revealed a clear view of the trachea (Cormack & Lehane grade 1) with no evidence of gastric contents’. The patient remained stable throuout the remainder of the operation. There was no clinical evidence of aspiration and a post-op chest X-ray revealed clear lung fields. It transpired the patient had consumed a can of Coca-Cola a few hours prior to the operation, something he failed to mention during  a pre-operative visit! An interesting case suggesting i-gel provided valuable assistance with the recognition and management of regurgitation.

Ref: . Liew, B. John, S. Ahmed (2008) Aspiration recognition with an i-gel airway
Anaesthesia 63 (7) , 786–786

This case study describes successful fibre-optic guided tracheal intubation through the i-gel in two uncooperaitve adult patients with learning disability and predicted difficult airway. The i-gel maintained the airway immediately after induction, allowing oxygenation and ventilation. Fibreoptic identification of the laryngeal inlet was successful on the first attempt and a tracheal tube inserted into the trachea, without complication, in both patients.

You can download the whole paper here (122k PDF)

Inventor of the i-gel, Dr. Muhammad Nasir will be speaking at the ABBSAT conference in Leipzig, Germany. This event takes place on the 20th-21st June and representatives from Intersurgical GmbH will be in attendance, along with members of our UK team.

Dr Nasir, i-gel inventor will be speaking about the research and development of the i-gel at the 9th Wexham Advanced Airway Workshop at Wexham Park Hopsital in Slough on the 16th June.

DAS overview of the workshop:
This workshop is geared towards trainees wishing to refresh and update skills in airway management. There are lectures, interactive discussions and over 4 hours of hands-on workshop training. The course provides intensive practical tuition on manikin and animal models. There is a highly experienced faculty who have been conducting very popular airway workshops in Hungary and Estonia and Wexham too!