Bhandari Geeta, Shahi K S, Asad Mohd, Parmar Nitish Kumar, Bhakuni Rajni
Department of Anesthesiology, Govt. Medical College, Haldwani (Nainital), Uttarakhand, India.
Department of Surgery, Govt. Medical College, Haldwani (Nainital), Uttarakhand, India.
Anesth Essays Res. 2013 Jan-Apr;7(1):94-9. doi: 10.4103/0259-1162.114012.
The i-gel is a novel supraglottic airway device with a soft and non-inflatable cuff. In our study we attempted to evaluate the performance of i-gel as a ventilatory device, as a conduit to blind tracheal intubation using conventional polyvinyl chloride tracheal tube and gastric tube insertion through it.
A total of 180 patients of American Society of Anesthesiologist (ASA) physical status I/II undergoing elective surgery under general anesthesia were included in this study. After induction of anesthesia, i-gel was inserted and the following parameters were recorded: Time taken for successful i-gel insertion, airway leak pressures, ease of gastric tube insertion and laryngeal view using fiberscope. Following this blind tracheal intubation was attempted. First attempt and overall success rate in blind tracheal intubation and gastric tube insertion were evaluated and tracheal intubation time was measured. Also presence of any side effects or complication following removal was recorded.
We achieved a 100% success rate in insertion of i-gel and in 171 out of 180 patients; i-gel was inserted in the 1(st) attempt itself. We also were able to achieve an overall success rate for blind endotracheal intubation via i-gel in 78.33% cases, and successful gastric tube placement was possible in 92.22%. In our study we also achieved a leak pressure of 25.52 (±2.33) cm of H2O.
I-gel may be effectively used for ventilation, nasogastric tube insertion and as a conduit to blind endotracheal intubation with minimal complication and acceptable airway sealing pressures.
i-gel是一种新型的声门上气道装置,带有柔软且不可充气的套囊。在我们的研究中,我们试图评估i-gel作为通气装置的性能,作为使用传统聚氯乙烯气管导管进行盲视气管插管的通道以及通过它插入胃管的情况。
本研究纳入了180例美国麻醉医师协会(ASA)身体状况为I/II级、在全身麻醉下接受择期手术的患者。麻醉诱导后,插入i-gel并记录以下参数:i-gel成功插入所需时间、气道泄漏压力、胃管插入的难易程度以及使用纤维喉镜观察的喉部视野。在此之后尝试进行盲视气管插管。评估盲视气管插管和胃管插入的首次尝试成功率和总体成功率,并测量气管插管时间。同时记录拔除后是否存在任何副作用或并发症。
我们在插入i-gel方面的成功率达到了100%,180例患者中有171例在第一次尝试时就成功插入了i-gel。我们还能够通过i-gel在78.33%的病例中实现盲视气管插管的总体成功率,并且胃管成功置入率为92.22%。在我们的研究中,我们还获得了25.52(±2.33)cmH₂O的泄漏压力。
i-gel可有效地用于通气、鼻胃管插入以及作为盲视气管插管的通道,并发症最少且气道密封压力可接受。