I-Gel and Classic LMA - a Comparitive Study in Anaesthetized and Paralyzed Patients

This study was undertaken in 50 ASA 1 and 2 patients of age group 18 to 60 years undergoing elective surgeries of short duration. Patients were randomly divided into 2 groups of 25 each for i-gel and classic LMA. Parameters assessed were - ease of insertion of airway device i.e. no. of attempts required and time taken for effective airway establishment (TFEA), ease of gastric tube placement, gastric insufflation and regurgitation (by comparing pH of the secretions on the dorsal surface of both the devices with sensitive litumus paper), hemodynamic response to insertion of device and post-operative sore throat following general anaesthesia. Incidents like desaturation, laryngospasm, bronchospasm, gastric insufflations were noted. The mode of induction, maintenance and reversal of general anaesthesia remained the same for both the groups. Demographic data between the two groups i.e. age, weight, sex, duration of surgery was comparable and with no statistical difference between them. There was one incidence of failure of insertion with Classic LMA to achieve effective airway. Success rate of device insertion was higher for i-gel than classic LMA and was statistically significant. Mean attempt for i-gel was 1.12 (S.D 0.332), classic LMA 1.45 (S.D 0.588). Time required for effective airway establishment was shorter with i-gel 20.24 seconds (S.D 22.408) than classic LMA 52.458 (S.D 41.341) and was statistically significant P < 0.05. There were no statistical and clinical differences in hemodynamic responses to insertion of both the devices. After removal at the end of surgery blood was visible on cuffs of 3 Classic LMAs but not on any of the i-gels. No statistical difference was found in pH of the cuffs of both the devices after removal. Incidence of post-operative sore throat was more with classic LMA (mean rank 31.25) than i-gel (mean rank 19) and was statistically significant P < 0.05. To conclude i-gel is easier to insert than Classic LMA and also facilitates gastric tube placement. i-gel is appropriate device for airway management as an alternative or backup device to Classic LMA. i-gel is less traumatic to airway than Classic LMA and correctly positioned i-gel isolates glottis from upper esophagus and provides airway protection.