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Table of Contents
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
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-9185.105826

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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 2021 Jun 21];29:128-9. Available from:


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
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
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
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
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

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Anaesthesia. 2014; : n/a
[Pubmed] | [DOI]


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