Background & Objectives: Intubating laryngeal mask airway (ILMA) is a supraglottic airway device (SAD) frequently used as conduit for endotracheal intubation when intubation under direct laryngoscopy is undesirable. A newer SAD i-gel is popular now because of its ease of insertion and performance. It can be used as a conduit for endotracheal intubation also. This study compared the success rate of blind endotracheal intubation through ILMA and i-gel

Methods: A total of 86 patients undergoing elective surgery under general anaesthesia were divided in two groups of 43 patients each to receive intubation through the ILMA (Group L) or i-gel (Group G). Anaesthesia was induced and selected SAD was inserted. After confirming adequate ventilation with the SAD, blind endotracheal intubation was attempted through the SAD. Success of intubation was noted and time taken for tracheal intubation was measured. IBM SPSS Statistics 20.0 software was used to analyse the data. P < 0.05 was considered as statistically significant.

Conclusion: ILMA is superior to i-gel as a conduit for blind endotracheal intubation because of its overall higher success rate. However, the statistically similar success rate in first attempt of tracheal intubation and the significantly lesser time required for insertion of i-gel make it a reasonable alternative to ILMA for intubation and an excellent choice for rescue ventilation.

Keywords- Intubating laryngeal mask airway; i-gel; Endotracheal intubation; Supraglottic airway device

1. Sastre JA, Lopez T, Garzon JC. [Blind tracheal intubation through two supraglottic devices: i-gel versus Fastrach intubating laryngeal mask airway (ILMA)]. Revistaespanola de anestesiologia y reanimacion. 2012 Feb;59(2):71-6.
2. Bhandari G, Shahi KS, Bhakuni R. A comparative study of tracheal intubation through i-gel® and Intubating Laryngeal Mask Airway (ILMA®).
3. Halwagi AE, Massicotte N, Lallo A, Gauthier A, Boudreault D, Ruel M, Girard F. Tracheal intubation through the I-gelTMsupraglottic airway versus the LMA FastrachTM: a randomized controlled trial. Anesthesia& Analgesia. 2012 Jan 1;114(1):152-6
4. Brain AI, Verghese C, Addy EV, Kapila A. The intubating laryngeal mask. I: Development of a new device for intubation of the trachea. British Journal of Anaesthesia. 1997 Dec 1;79(6):699-703
5. Theiler L, Kleine-Brueggeney M, Urwyler N, Graf T, Luyet C, Greif R. Randomized clinical trial of the i-gel™ and Magill tracheal tube or single-use ILMA™ and ILMA™ tracheal tube for blind intubation in anaesthetized patients with a predicted difficult airway. British journal of anaesthesia. 2011 Aug 1;107(2):243-50.
6. Sreevathsa S, Linga Nathan P, John B, Danha RF, Mendonca C. Comparison of fibreoptic‐guided intubation through ILMA versus intubation through LMA‐ Anaesthesia. 2008 Jul 1;63(7):734-7.
7. Taxak S, Vashisht K, Kaur KP, Ahlawat G, Bhardwaj M. A study to evaluate fibreoptic-guided intubation through the i-gel™. Southern African Journal of Anaesthesia and Analgesia. 2013 Jan 1;19(2):120-3.
8. Levitan RM, Kinkle WC. Initial anatomic investigations of the I‐gel airway: a novel supraglottic airway without inflatable cuff. Anaesthesia. 2005 Oct 1;60(10):1022-6.
9. Jerry A. Dorsch, Dorsch SE. Supraglottic Airway Devices. In: Dorsch JA, editor. Understanding anesthesia equipment. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 462–520.
10. Kapoor S, Jethava DD, Gupta P, Jethava D, Kumar A. Comparison of supraglottic devices i-gel® and LMA Fastrach® as conduit for endotracheal intubation. Indian journal of anaesthesia. 2014 Jul 1;58(4):397
11. Henderson J. Airway management in the adult. In: Miller R, editor. Miller’s anesthesia. 7th ed. Philadelphia: Elsevier Health Sciences; 2010. p. 1573–610
12. Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, O'Sullivan EP, Woodall NM, Ahmad I. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. British journal of anaesthesia. 2015 Dec 1;115(6):827-48
13. Theiler L, Gutzmann M, Kleine-Brueggeney M, Urwyler N, Kaempfen B, Greif R. i-gel™ supraglottic airway in clinical practice: a prospective observational multicentre study. British journal of anaesthesia. 2012 Sep 6:109(6):990–5
14. Henderson JJ, Popat MT, Latto IP, Pearce AC. Difficult Airway Society guidelines for management of the unanticipated difficult intubation. Anaesthesia. 2004 Jul 1;59(7):675-94

Dr Sunil.R

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.