A comparative study of I-gel and LMA fastrach as a conduit for blind endotracheal intubation

ABSTRACT

Background: The most important duty of an anesthesiologist is to protect the patient‟s airway and to provide adequate ventilation. The anesthesiologist should be skilled enough to make decisions at the circumstances of difficult intubations. We compared the success rate of blind tracheal intubation through two different supraglottic airway devices, I-GEL and ILMA using PVC endotracheal tube. We studied the complications in both the techniques. The aim of the study To compare the advanced I-GEL, to ILMA as a conduit for blind endotracheal intubation for patients posted for elective procedures under general anesthesia. Materials and methods: A Prospective randomized study was conducted in 80 adult patients who undergone elective surgery under general anesthesia. They were divided into 2 groups- each group included 40 patients. Group A - I-GEL, Group B- ILMA. We noted the Ease of insertion, Duration of successful attempts, No. of failed attempts, Total intubation time and First attempt success rate. We recorded Heart rate, Blood pressure, Pulse oximetry, EtCO2 and Complications of I-gel and ILMA insertion. Results: Supraglottic device insertion time (15.62s vs 17.17s) and Supraglottic device removal time (15.82s vs 16.55s) were the least I-GEL group. The first attempt success rate for tracheal intubation (87.5% vs 60%) and Success rate for insertion (95% vs 72.5%) were high in the ILMA group. There was no statistical difference in Total intubation time, Complications, Hemodynamic response to intubation, No. of attempts for supraglottic device insertion and Time for first attempt tracheal intubation. Ebenezer Joel Kumar E, Bridgit Merlin J, Anu Asheetha R. A comparative study of I-gel and LMA fastrach as a conduit for blind endotracheal intubation. IAIM, 2019; 6(2) 87-95. Page 88 Conclusion: We concluded I-GEL aids easy and rapid insertion as a supraglottic airway device, but when it is used as a conduit for blind endotracheal intubation, the failure rate is high as there is more incidence of oesophageal intubation. On the contrary, ILMA being a gold standard device meant for intubation guide has a high first attempt success rate for blind endotracheal intubation.