The Clinical Studies Of I-Gel Laryngeal Mask Airway(I-Gel) For Airway Management During Operation

Objective:Clinical Study I:To compare the ventilation through I-Gel laryngeal mask airway (I-Gel) and Proseal laryngeal mask airway (LMA-P) during general anesthesia. Clinical study II:To evaluate the effects of fiberoptic intubation through I-Gel Supraglottic airway in the patients scheduled for cervical spine surgery.Methods:Clinical Study I:sixty ASA Ⅰ or Ⅱ patients (BMI<30kg/m2) undergoing elective surgery were randomized into2groups (n=30):group Ⅰ-Gel(Ⅰ-Gel)and group LMA-Proseal(LMA-P). After the patient was induced, I-Gel and LMA-P were inserted respectively in the groups. Fiberoptic bronchoscope scores were assessed after successful insertion. The insertion time of LMA, ease of insertion, the rate of successful insertion of a gastric tube at first attempt, airway seal pressure were recorded. BP, HR, ECG, SpO2, PETCO2and Ppeak were continuously monitored and MAP and HR were recorded during the operation. The duration of operation, recovery time, extubation time and pharyngeal adverse responses at24h after during were recorded. Clinical study Ⅱ:40ASA Ⅰ～Ⅱ patients aged36-62yrs scheduled for cervical spine surgery were randomly divided into2groups(n=20each):group O (fiberoptic intubation through oropharynx ventilation tube) and group I (fiberoptic intubation through I-Gel Supraglottic airway). The intubation time and the rate of successful intubation were recorded; the fiberoptic bronchoscope scores were assessed; MAP and HR were recorded before anesthesia induction and intubation (Ti), after anesthesia induction (T2), after successful oropharynx ventilation tube or I-Gel Supraglottic airway placement (T3) and after successful fiberoptic intubation (T4). All patients were followed up postoperatively for adverse effects like sore throat or hoarseness, etc.Results:Clinical Study I:The rate of total successful insertion, the duration of operation and recovery time and extubation between the2groups were no significant differences (P>0.05). Compared with group LMA-P, the insertion time of LMA, ease of insertion, airway seal pressure were significantly decreased in group I-Gel. There were no significant differences in the rate of successful insertion of a gastric tube at first attempt. The hemodynamics was stable during operation in both groups. BP, HR, ECG, SpO2, PETCO2and Ppeak were within normal limits and comparable between the2groups. The Fiberoptic bronchoscopic scores were significantly higher in group I-Gel,(P<0.05). Pharyngeal adverse responses at24h after operation were significantly decreased in I-Gel group. Clinical study Ⅱ:Compared with the group O(95±25s), The intubation time in group I was63±11s,(P<0.05). The rate of successful intubation were significantly higher in group O than in group I (P<0.05). Fiberoptic views through I-Gel Supraglottic airway were improved markedly in group I than in group O. MAP and HR were significantly higher at T4than Ti in two groups(P<0.05). There was no significant difference in the incidence of Pharyngeal adverse responses in2groups.Conclusion:Clinical Study I:I-Gel is superior to LMA-Proseal in terms of ease of insertion, can be safely and effectively used in general anesthesia. Clinical study II: Tracheal intubation with FOB through an I-Gel supraglottic airway provides less time to endotracheal intubation and higher success rate in the patients scheduled for cervical spine surgery than through oropharynx ventilation tube.