Anesth Pain Med.  2016 Jul;11(3):307-312. 10.17085/apm.2016.11.3.307.

A comparison of ProSeal laryngeal mask airway, I-gel and endotracheal tube insertion by novices in a simulated difficult airway scenario

• Park SJ
• Jung J
• Shim SY
• Lee DH

• KMID: 2344937
• DOI: http://doi.org/10.17085/apm.2016.11.3.307

Abstract

BACKGROUND
Insertion of supraglottic airway devices (SADs) can be technically easier to perform for novices than endotracheal intubation (ETI), particularly in a situation with difficult airway management. We evaluated the efficacy and usefulness of the ProSeal laryngeal mask airway (PLMA), I-gel, and ETI when used by novices in a simulated difficult airway scenario.
METHODS
A total of 109 novices participated in a brief educational session about PLMA, I-gel and ETI. The sequence of the airway devices was randomized for each participant using a computer-generated random table, and the devices were inserted in a manikin with restricted cervical spine movement. A nasogastric (NG) tube was then inserted through each SAD. In the case of ETI, the NG tube was inserted through the manikin's nostril.
RESULTS
The success rate at the first insertion attempt was 93.6% for the I-gel compared with 72.5% for the PLMA and 19.3% for ETI. The I-gel also enabled a significantly shorter insertion time than the PLMA (I-gel 26.3 ± 21.9 sec and PLMA 36.0 ± 35.4 sec). The novices showed high success rates for NG tube insertion using SADs (PLMA 96.3% and I-gel 98.1%) compared with ETI (24.8%).
CONCLUSIONS
We found that the I-gel provided a better first time success rate and a shorter insertion time than PLMA and ETI, which indicated that the I-gel may be preferable for difficult airway management by novices.

Keyword

Intubation; Laryngeal mask; Manikin

MeSH Terms

Airway Management
Intubation
Intubation, Intratracheal
Laryngeal Masks*
Manikins
Spine

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