i-gel® supraglottic airway

Author: 
Claas Siegmueller

 

FEATURES

The i-gel® is a second generation supraglottic airway device made from a thermoplastic elastomer, which makes it PVC and latex-free. It features a non-inflating cuff, an integrated bite block and a gastric channel/ drain tube (the size 1 neonatal i-gel does not have this gastric channel). It does not have aperture bars  like the LMA Unique®. It does feature an epiglottic rest/ ridge just above the distal opening. Another distinctive feature is the 'buccal cavity stablizer', which refers to the widened portion of the body, designed to aid insertion and prevent unintended rotation once placed. A horizontal bar indicator at the proximal end gives a clue towards the optimal insertion depth.

i-gel® SGA with recommended weight range in insertion depth guide (at teeth)
Epiglottic rest/ ridge
Distal and proximal opening of gastric channel/ drain tube

 

There appears to be a widely held belief that the cuff of the i-gel® expands at body temperature after insertion and somehow moulds itself to the larynx for a better seal. This is not true!

The i-gel® device is offered in the following sizes: 1, 1.5, 2, 2.5, 3, 4, and 5.

If you want to intubate through the i-gel® as a conduit these are the maximum ET tube sizes that fit throught it:

Maximum ET tube sizes that can be passed throug different SGAs; MLT®= microlaryngoscopy tube

Gastric channel

According to the manufacturer, the i-gel acommodates the following size suction catheters through the gastric channel: Sizes 2- 4 can take a 12 Fr suction or nasogastric tube, and size 5 can accomodate a 14 Fr one. You will most definetely need a lubricating gel to be able to advance a suction tube through the gastric channel.


USES

The indications (and contraindications) for the i-gel are generally the same as for other supraglottic airways and are discussed in the 'SGA placement' page.


REFERENCES

Theiler, L.; Gutzmann, M.; Kleine-Brueggeney, M.; Urwyler, N.; Kaempfen, B.; Greif, R. (2012): i-gel™ supraglottic airway in clinical practice. A prospective observational multicentre study. In British Journal of Anaesthesia 109 (6), pp. 990–995. DOI: 10.1093/bja/aes309.

Shin, Won-Jung; Cheong, Yu-Seon; Yang, Hong-Seuk; Nishiyama, Tomoki (2010): The supraglottic airway I-gel in comparison with ProSeal laryngeal mask airway and classic laryngeal mask airway in anaesthetized patients. In European journal of anaesthesiology 27 (7), pp. 598–601. DOI: 10.1097/EJA.0b013e3283340a81.

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