Comparison of size 2 i-gel supraglottic airway with LMA-ProSeal™ and LMA-Classic™ in spontaneously breathing children undergoing elective surgery.

BACKGROUND: We compared size 2 i-gel(®) (Intersurgical Inc.), a relatively new supraglottic airway device for use in spontaneously breathing anesthesized children with two different types of laryngeal mask airway-ProSeal™ laryngeal mask airway (PLMA) and Classic™ laryngeal mask airway (cLMA) for the ease of insertion, oropharyngeal sealing pressures (OSPs), and air leak. The hemodynamic effects on insertion of device and postoperative adverse effects were also noted.

METHODS: A randomized prospective study was planned in 120 children aged 2-5 years, weighing 10-20 kg, ASA physical status I-II scheduled for routine elective surgeries of <1-h duration. They were randomly divided in three groups (i-gel, PLMA, and cLMA) of 40 each, and a standard protocol for anesthesia was followed.

RESULTS: The age, weight, height, and type of surgery were similar in all groups. Success rate for first attempt was 95% for the i-gel group and 90% for the two laryngeal mask airway groups. Insertion was found to be easy in the majority of cases in all groups, and there was no change in blood pressure, heart rate, or oxygen saturation on insertion. The OSP was 26 ± 2.6, 23 ± 1.2, and 22 ± 2.3 cm H(2)O for i-gel, PLMA, and cLMA, respectively. The difference between the i-gel and both laryngeal mask airway groups was statistically significant (P < 0.01). There were no clinically important complications in the postoperative period.

CONCLUSION: Pediatric size 2 i-gel is easy to insert and provides higher OSP compared with same size PLMA and cLMA in spontaneously breathing children undergoing elective surgery. It may be a safe alternative to laryngeal mask airways in day care surgeries.