Indian Journal of Anaesthesia

CLINICAL INVESTIGATION
Year
: 2012  |  Volume : 56  |  Issue : 4  |  Page : 348--352

Randomized crossover comparison of the laryngeal mask airway classic with i-gel laryngeal mask airway in the management of difficult airway in post burn neck contracture patients


Jeevan Singh1, Manohar Kumar Yadav2, Sujan Babu Marahatta3, Bikash Lal Shrestha4 
1 Department of Anaesthesia, Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS) Post Box Number: 11008, Dhulikhel, Kavre, Nepal
2 Sushma Koirala Memorial Hospital for Plastic and Reconstructive Surgery, Shankhu, Kathmandu, Nepal
3 Department of Community Medicine, Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS) Post Box Number: 11008, Dhulikhel, Kavre, Nepal
4 Department of ENT, Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS) Post Box Number: 11008, Dhulikhel, Kavre, Nepal

Correspondence Address:
Jeevan Singh
Department of Anaesthesia, Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS) Post Box Number: 11008, Dhulikhel, Kavre
Nepal

Purpose: The objective of the study was to compare the performance of i-gel supraglottic airway with cLMA in difficult airway management in post burn neck contracture patients and assess the feasibility of i-gel use for emergency airway management in difficult airway situation with reduced neck movement and limited mouth opening. Methods: Prospective, crossover, randomized controlled trial was performed amongst forty eight post burn neck contracture patients with limited mouth opening and neck movement. i-gel and cLMA were placed in random order in each patient. Primary outcome was overall success rate. Other measurements were time to successful ventilation, airway leak pressure, fiberoptic glottic view, visualization of square wave pattern. Results: Success rate for the i-gel was 91.7% versus 79.2% for the cLMA. i-gel required shorter insertion time (19.3 seconds vs. 23.5 seconds, P=0.000). Airway leak pressure difference was statistically significant (i-gel 21.2 cm H20; cLMA 16.9 cm H 2 0; P=0.00). Fiberoptic view through the i-gel showed there were less epiglottic downfolding and better fiberoptic view of the glottis than cLMA. Overall agreement in insertion outcome for i-gel was 22/24 (91.7%) successes and 2/24(8.3%) failure and for cLMA, 19/24 (79.16%) successes and 5/24 (16.7%) failure in the first attempt. Conclusion: The i-gel is cheap, effective airway device which is easier to insert and has better clinical performance in the difficult airway management of the airway in the post burn contracture of the neck. Our study shows that i-gel is feasible for emergency airway management in difficult airway situation with reduced neck movement and limited mouth opening in post burn neck.


How to cite this article:
Singh J, Yadav MK, Marahatta SB, Shrestha BL. Randomized crossover comparison of the laryngeal mask airway classic with i-gel laryngeal mask airway in the management of difficult airway in post burn neck contracture patients.Indian J Anaesth 2012;56:348-352


How to cite this URL:
Singh J, Yadav MK, Marahatta SB, Shrestha BL. Randomized crossover comparison of the laryngeal mask airway classic with i-gel laryngeal mask airway in the management of difficult airway in post burn neck contracture patients. Indian J Anaesth [serial online] 2012 [cited 2020 Oct 31 ];56:348-352
Available from: https://www.ijaweb.org/article.asp?issn=0019-5049;year=2012;volume=56;issue=4;spage=348;epage=352;aulast=Singh;type=0