Conventional versus reverse insertion of i-gel® in overweight and obese patients - Interventional randomised controlled trial.

Background And Aims: The supraglottic airway device, i-gel, is used in obese patients for short- to medium-duration surgical procedures. Insertion techniques have contributed to the successful and proper placement of i-gel in the first attempt. This study aims to compare two techniques for successfully inserting i-gel in the first attempt in overweight and obese patients as measured by oropharyngeal leak pressure (OLP).

Methods: This interventional, randomised, controlled study was conducted after ethical approval, and trial registration in overweight and obese patients. Patients were randomised into two groups: In Group C, the conventional technique was used, while in Group R, the reverse technique was used to insert i-gel. OLP, successful placement, required manipulations, time taken for insertion, number of attempts, and intraoperative and postoperative complications were studied. The collected data were analysed statistically.

Results: The mean OLP (30.46 ± 3.76 vs. 32.12 ± 3.10 mmHg, = 0.018) and the mean time of insertion (16.42 ± 1.86 vs. 13.98 ± 1.97 s, = 0.001) for conventional and reverse techniques, respectively, were statistically significant and favourable for Group R compared to Group C. Successful placement of i-gel at the first attempt, ease of insertion, number of attempts and all the manipulations except withdrawal and advancement were comparable in both the groups. No postoperative complications were noted.

Conclusion: The reverse technique significantly favoured the actual OL values and the mean insertion time. Successful placement of i-gel at the first attempt was observed with both conventional and reverse techniques.