CLINIPICS – April 2013

Optimising the length of i-gel

Tariq Hayat Khan, Amna Ghayas, Ayesha, Shiraz Naeem, Naeem Khan

KRL General Hospital, Islamabad (Pakistan)

i-gel is being widely used as a supraglottic airway device, in spontaneously breathing patients as well as for mechanical ventilation. It has been used as an emergency use airway device with success. The manufacturer has launched i-gel in many sizes. Each size is recommended for patients of a particular weight category, e.g. size 1 for 2-5 kg, size 1.5 for 5-12, size 2 for 10-25 and size 2.5 for 25-35 kg body weight. We observed that the length of the connector as well as the shaft of the i-gel for these smaller sizes is in excess of what is required, thus adding to dead space and difficulty in holding it firmly in place. No filter was used in both of these patients to reduce the resistance to spontaneous breathing and the dead space.

References:

  1.  Wharton NM, Gibbison B, Gabbott DA, Haslam GM, Muchatuta N, Cook TM. I-gel insertion by novices in manikins and patients. Anaesthesia. 2008 Sep;63(9):991-5.
  2. Soar J: The i-gel supraglottic airway and resuscitation – some initial thoughts Resuscitation: doi: 10.1016/j.
  3. Schmidbauer W, Bercker S, Volk T, Bogusch G, Mager G, Kerner T: Oesophageal seal of the novel supralaryngeal airway device i-gel in comparison with the laryngeal mask airways Classic and ProSeal using a cadaver model: BJA doi:10.1093/bja/aen319
  4. Liew, B. John, S. Ahmed (2008) Aspiration recognition with an i-gel airway: Anaesthesia 63 (7);786.

Figure 1&2: Intact i-gel size 1.5 and 2 in use. Note the extra long shaft and the connector

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Figure 3: Size 2 i-gel in use, which was cut short by 4 cm

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Figure 4: An intact and a cut i-gel size 2

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