Analysing the efficacy of the I-gel supraglottic airway device in the supine and lateral decubitus positions.

Background: The advantages of the I-gel supraglottic airway device include ease and speed of insertion, reduced trauma incidence, an integral bite block, gastric access, a non-inflatable cuff and superior seal pressure. The primary goal of this study was to compare airway leak pressures and the fibreoptic view in the supine and lateral positions. Our secondary aim was to analyse the effects of I-gel insertion on haemodynamic parameters.

Methods: One hundred patients undergoing saturation biopsy due to prostatic hyperplasia were recruited to this prospective randomised study. An I-gel device was inserted in the supine position. Taking of measurements, patients were placed in the lateral decubitus position. Mean arterial pressure, heart rate, peripheral O₂ saturation and end-tidal CO₂ were recorded before and after insertion. We recorded the number of attempts and insertion time for the I-gel device. Oropharyngeal leak pressures and I-gel device positioning were scored in the lateral decubitus and supine positions.

Results: It was possible to insert the I-gel device in 88 patients on the first attempt. The median time for insertion was 7.97 ± 2.18 sec. The mean arterial pressure and heart rate decreased 1 and 2 min after insertion. Oropharyngeal leak pressure was similar in the supine (27.45 ± 5.37 mm Hg) and lateral decubitus positions (26.04 ± 4.92 mm Hg) (P > 0.05). On fibreoptic examination through the I-gel device, the scores of patients were comparable in different positions (P = 0.542).

Conclusion: As there was no significant difference in oropharyngeal leak pressure and fibreoptic view, we concluded that the I-gel device may be used safely in both the supine and lateral positions.