Use of an i-gel for airway rescue
The correspondence section of the September edition of ‘Anaesthesia’, includes a letter from three anaesthetists at the Royal United Hospital Bath, UK, describing successful airway rescue with an i-gel in a case of failed ventilation and predicted difficult intubation, after two other well known competitor brands of supraglottic airway had failed.
The patient, a middle-aged obese female, scheduled for an elective hand operation, had a Mallampati score of 3 and mouth opening of 3cm. Following induction of anaesthesia, facemask ventilation with an oropharyngeal airway was found to be extremely difficult and oxygenation saturation fell rapidly. Two other well known brands of supraglottic airway were initially tried, but although insertion with both was performed easily, ventilation was not possible with either device. Rescue facemask ventilation again proved difficult and a size 4 i-gel was easily inserted. i-gel, ‘immediately provided unobstructed ventilation and stable oxygen saturation of 98%’. IPPV produced ‘good ventilation and peak airway pressures of 25cm H2O for the remainder of the case’.
The authors comment on the potential role of the device in airway rescue where other more established supraglottic airway devices have failed. They also report that discussion with colleagues revealed that two other anaesthetists had also experienced cases where i-gel had been used successfully after the failure of other supraglottic airways. They concluded that, ‘the i-gel’s role in difficult airway management remains to be established’, but certain features of the device make it a, ‘potentially useful airway device in cases of difficult mask ventilation’. The complete correspondence can be obtained from the following link; http://www3.interscience.wiley.com/journal/121371462/abstract
