One Year Randomized Clinical Trial To Compare Efficacy Of I-Gel Supraglottic Airway And Classic Laryngeal Mask Airway For Ease Of Insertion In Paediatric Patients Undergoing General Anaesthesia

Abstract

Introduction: Management of the airway has come a long way since the development of endotracheal intubation to the present day usage of supraglottic airway devices. The classic LMA (cLMA) has revolutionized paediatric anaesthetic practice. The i-gel is a recent novel supraglottic airway device designed to fit the pharyngeal, laryngeal and perilaryngeal structures without use of an inflatable cuff. Hence, we designed this study to compare the clinical efficacy of i-gel (size 2) and classic LMA (size 2) for ease of insertion, airway sealing pressure, duration of insertion and complications in paediatric patients posted for elective surgeries under general anaesthesia. Methodology: The present randomized clinical trial was conducted in 80 ASA I and II paediatric patients aged between 1-6 years, weighing 10 to 20 Kgs posted for surgeries under general anaesthesia in KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. Patients were allocated into two equal groups, Group A. classic LMA (n=40) and Group B. i-gel (n=40). All the data collected were analysed. The demographic data, duration of insertion and airway seal pressure were analysed using unpaired‘t’ test. Sex and complications were compared using chi square test. Ease of insertion was analysed using fisher exact test. RESULTS: In our study, insertion was very easy in 26 patients in group cLMA and 31 patients in group i-gel, easy in 13 patients in group cLMA and 9 patients in group i-gel. Difficult insertion was seen in 1 patient in group cLMA. These differences are not statistically significant (p=0.323). The mean duration of insertion was 20.85+3.26 sec in group cLMA and 20.17+2.43 sec in group i-gel, which is not significant (p=0.298). The mean airway sealing pressure was 21.52+1.43 in group cLMA and 27.1+1.19 in group i-gel which is statistically significant (p<0.001). No significant complications were noted in both groups. CONCLUSIONS: The i-gel (size 2) is easier to insert, provides a higher airway sealing pressure compared to cLMA and hence can be safely used in paediatric patients.