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Supraglottic Airway Devices I-Gel And ILMA (Intubating Laryngeal Mask Airway) for Ease of Insertion and as Conduit for Blind Endotracheal Intubation: A Prospective Comparative Study

K. Senthil Kumar, Assistant Professor, Dept. of Anesthesiology, Kilpauk Medical College, Kilpauk, Chennai, Tamil Nadu 600010, India. , K. Senthil Kumar1 , Amala Savio A.2

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Indian Journal of Anesthesia and Analgesia 4(3):p 805-814, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.42

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Abstract

Introduction: Supraglottic airway devices are helpful in patients with difficult airways and in emergency situations and in cardiopulmonary resuscitations [1]. Some supraglottic airway devices are used for blind or fibreoptic bronchoscopy {FOB} guided intubation in the airway management . They can be efficiently used as rescue airway devices in patients with difficult airway and their use has increased in anaesthesia practice and emergency medical services [2]. Aim: This study is done to evaluate the efficacy of supraglottic airway devices I-GEL and ILMA as emergency ventilatory devices by comparing ease of insertion and as conduits for blind endotracheal intubation which can be used in difficult intubating conditions. Methods: 60 patients posted for surgical procedures under general anaesthesia. Patients fulfilling inclusion criteria were included in the study and were enrolled and analysed.Patients induced with appropriate Induction gents and Non depolarizing muscle relaxants and ventilated for 3 min prior to SAD insertion and again ventilated for one minute prior to blind ETT intubation. Group A: ILMA ( 30 ) inserted after 3 min ventilation followed by blind ETTintubation. Group B: I GEL (30) inserted after 3 min ventilation followed by blind ETTintubatio. Variables such as ease of insertion, number of attempts and duration of insertion of SADS, number of attempts and duration of blind ETT insertion and postoperative sorethroat, dysphagia etc were compared. The collected data were statistically analysed and tabulated. Results: The statistical analysis tools used in this study for the comparison of demographic variables, ease of insertion, number of attempts and duration of insertion of SAD, number of attempts and duration for ETT insertion ,failure and postoperative sorethroat and dysphagia were chi square test and fishers exact test. The p value derived for ease of insertion, number of attempts, and duration of insertion of SGADS I-GEL and ILMA were p < 0.001 favouring I- GEL. Likewise the p value derived for number of attempts and duration for ETT insertion through I-GEL and ILMA were p< 0.0001 favouring ILMA . The p value derived for incidence of postoperative sore throat and dysphagia was p<0.0125, favouring I-GEL. It was concluded that from above results that I-GEL is a better device for emergency rescue ventilation because of its ease of insertion and lesser incidence of postoperative sore throat and dysphagia as compared to ILMA whereas ILMA is a better device for blind endotracheal intubation compared to I-GEL. Conclusion: It can be safely concluded that I-GEL is easier to insert and a better airway device for emergency rescue ventilation compared to ILMA and ILMA is a better conduit for blind endotracheal intubation than I-GEL.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.42

Keywords

I-GEL; ILMA; Endotracheal Intubation. 

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