Prewarming of the i-gel facilitates successful insertion and ventilation efficacy with muscle relaxation: a randomized study.

STUDY OBJECTIVE

To determine if prewarming of the i-gel (Intersurgical, Wokingham, United Kingdom) improves insertion and ventilation efficacy with muscle relaxation in patients undergoing elective surgery.

DESIGN

Clinical randomized study.

SETTING

Operating room.

PATIENTS

Sixty-eight adult patients scheduled for elective surgery under general anesthesia with American Society of Anesthesiologists physical status 1-3.

INTERVENTIONS

The i-gel was warmed to 42°C for 30 minutes before insertion (W group; 34 patients) or kept at room temperature (approximately 23°C) (C group; 34 patients).

MEASUREMENTS

The number of attempts for a successful insertion and the sealing pressure and leak volume 30 seconds and 30 minutes after initiating mechanical ventilation.

MAIN RESULTS

The total insertion attempts were 1 (W group, 31 cases; C group, 24 cases) and 2 (W group, 3 cases; C group, 10 cases), which was significant (P = .001). Sealing pressure was significantly higher in the W group than the C group (W group, 21.8 ± 3.7 cm H2O; C group, 18.5 ± 3.4 cm H2O; P = .001). Leak volume was significantly smaller after 30 seconds in the W group than the C group (P = .002), but not after 30 minutes (P = .69).

CONCLUSIONS

Prewarming the i-gel to 42°C demonstrated a higher successful ventilation initiation.