Users Online: 130 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Login 


RSACP wishes to inform that it shall be discontinuing the dispatch of print copy of JOACP to it's Life members. The print copy of JOACP will be posted only to those life members who send us a written confirmation for continuation of print copy.
Kindly email your affirmation for print copies to dranjugrewal@gmail.com preferably by 30th June 2019.

 

 
Table of Contents
LETTER TO EDITOR
Year : 2013  |  Volume : 29  |  Issue : 1  |  Page : 128-129

Reverse technique for I-gel supraglottic airway insertion


Department of Anaesthesia and Intensive Care,Post Graduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication10-Jan-2013

Correspondence Address:
Indu Sen
C/O Dr. Ramesh Sen, Post Box 1519, Sector 12-A,PGI, Chandigarh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.105826

Rights and Permissions

How to cite this article:
Sen I, Bhardwaj N, Latha Y S. Reverse technique for I-gel supraglottic airway insertion. J Anaesthesiol Clin Pharmacol 2013;29:128-9

How to cite this URL:
Sen I, Bhardwaj N, Latha Y S. Reverse technique for I-gel supraglottic airway insertion. J Anaesthesiol Clin Pharmacol [serial online] 2013 [cited 2019 Nov 15];29:128-9. Available from: http://www.joacp.org/text.asp?2013/29/1/128/105826

Sir,

The I-gel (Intersurgical Ltd, Wokingham, UK) is a single-use extraglottic airway device with a non-inflatable cuff and an esophageal vent. [1] The device is used for maintaining the patency of airway during cardiopulmonary resuscitation for short surgical procedures and as a conduit for endotracheal tube insertion in difficult airway. I-gel has been compared with other extraglottic airway devices for ease of insertion. Most airway training manikin studies report a high success rate of >95%, even by inexperienced personnel. [1],[2] When I-gel was used for airway management in adult patients, a first time success rate of 86% has been reported. [3] Authors required 53 manipulations in 26 patients to achieve a clear airway. A problem of tongue folding during I-gel placement has been reported, though the patient had adequate mouth opening and full set of dentition. [4]

We successfully used the reverse insertion technique for I-gel airway in a 30-year-old woman, scheduled for hysteroscopic dilatation and curettage. The technique has been previously described for the insertion of Guedel's airway and classic Laryngeal Mask Airway (LMA). [5] Our patient received an induction dose of propofol, and I-gel was initially inserted orally using the standard insertion technique. However, the device could not be positioned properly due to repeated tongue folding. A reverse insertion technique, as reported for classic LMA, was then tried. The I-gel was inserted with concavity facing toward the hard palate. On reaching oropharynx, the device was rotated 180° and placed in its final position to facilitate positive pressure ventilation. This method is easy to use, atraumatic, and may be used for I-gel insertion if first attempt by classic technique fails.

 
  References Top

1.Stroumpoulis K, Isaia C, Bassiakou E, Pantazopoulos I, Troupis G, Mazarakis A, et al. A comparison of I-gel and classic LMA insertion in manikins by experienced and novice physicians. Eur J Emerg Med 2012;19:24-7.  Back to cited text no. 1
[PUBMED]    
2.Michalek P, Donaldson W, Graham C, Hinds JD. A comparison of the I-gel supraglottic airway as a conduit for tracheal intubation with the intubating laryngeal mask airway: A manikin study. Resuscitation 2010;81:74-7.  Back to cited text no. 2
[PUBMED]    
3.Gatward JJ, Cook TM, Seller C, Handel J, Simpson T, Vanek V, et al. Evaluation of the size 4 I-gel airway in one hundred non-paralysed patients. Anaesthesia 2008;63:1124-30.  Back to cited text no. 3
[PUBMED]    
4.Taxak S, Gopinath A. Insertion of the I-gel airway obstructed by the tongue. Anesthesiology 2010;112:500-1.  Back to cited text no. 4
[PUBMED]    
5.Ghai B, Makkar JK, Bhardwaj N, Wig J. Laryngeal mask airway insertion in children: Comparison between rotational, lateral and standard technique. Paediatr Anaesth 2008;18:308-12.  Back to cited text no. 5
[PUBMED]    



This article has been cited by
1 A prospective randomised comparison of two insertion methods for i-gel™placement in anaesthetised paralysed patients: standard vs rotational technique
H. C. Kim,D. H. Yoo,H. J. Kim,Y. T. Jeon,J. W. Hwang,H. P. Park
Anaesthesia. 2014; : n/a
[Pubmed] | [DOI]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
   References

 Article Access Statistics
    Viewed1550    
    Printed55    
    Emailed0    
    PDF Downloaded320    
    Comments [Add]    
    Cited by others 1    

Recommend this journal