Ahuja Sonali, Kaur Gurpreeti, Garg Kamakshi, Grewal Anju
Department of Anaesthesiology, DMCH Ludhiana, Punjab, India.
Indian J Anaesth. 2023 Aug;67(8):708-713. doi: 10.4103/ija.ija_749_22. Epub 2023 Aug 15.
The supraglottic airway device, i-gel, is used in obese patients for short- to medium-duration surgical procedures. Insertion techniques have contributed to the successful and proper placement of i-gel in the first attempt. This study aims to compare two techniques for successfully inserting i-gel in the first attempt in overweight and obese patients as measured by oropharyngeal leak pressure (OLP).
This interventional, randomised, controlled study was conducted after ethical approval, and trial registration in overweight and obese patients. Patients were randomised into two groups: In Group C, the conventional technique was used, while in Group R, the reverse technique was used to insert i-gel. OLP, successful placement, required manipulations, time taken for insertion, number of attempts, and intraoperative and postoperative complications were studied. The collected data were analysed statistically.
The mean OLP (30.46 ± 3.76 vs. 32.12 ± 3.10 mmHg, = 0.018) and the mean time of insertion (16.42 ± 1.86 vs. 13.98 ± 1.97 s, = 0.001) for conventional and reverse techniques, respectively, were statistically significant and favourable for Group R compared to Group C. Successful placement of i-gel at the first attempt, ease of insertion, number of attempts and all the manipulations except withdrawal and advancement were comparable in both the groups. No postoperative complications were noted.
The reverse technique significantly favoured the actual OL values and the mean insertion time. Successful placement of i-gel at the first attempt was observed with both conventional and reverse techniques.
声门上气道装置i-gel用于肥胖患者的中短期外科手术。插入技术有助于首次尝试时i-gel的成功且正确放置。本研究旨在比较在超重和肥胖患者中通过口咽漏气压（OLP）测量首次成功插入i-gel的两种技术。
本干预性、随机、对照研究在获得伦理批准并在超重和肥胖患者中进行试验注册后开展。患者被随机分为两组：C组采用传统技术，而R组采用反向技术插入i-gel。研究了OLP、成功放置情况、所需操作、插入时间、尝试次数以及术中及术后并发症。对收集的数据进行统计学分析。
传统技术和反向技术的平均OLP分别为（30.46±3.76对32.12±3.10 mmHg，P = 0.018），平均插入时间分别为（16.42±1.86对13.98±1.97秒，P = 0.001），与C组相比，R组在统计学上具有显著差异且更具优势。两组首次尝试时i-gel的成功放置、插入难易程度、尝试次数以及除拔出和推进外的所有操作均相当。未观察到术后并发症。
反向技术在实际OL值和平均插入时间方面具有显著优势。传统技术和反向技术在首次尝试时均成功放置了i-gel。
