Ease and accuracy of insertion : Laryngeal Mask Airway Classic vs i-gel ventilation in adults

Abstract

Background: Inadequate ventilation during surgery may cause numerous morbidities and also mortality. Cook, (2011) stated that, in a year, out of the 2.9 million surgeries performed in United Kingdom, 184 cases led to major complications of airway management, of which, 3 cases lead to persistent brain damage and 16 caused fatalities. Consequently, it is essential to use the easiest and safest airway device for proper ventilation maintenance. The research question created: Are Laryngeal mask airway ClassicTM or the i-gelTM easier and more accurate to insert to maintain ventilation in adult patients? PICO framework: (P) Adults needing ventilation (I) Laryngeal mask airway (C) i-gelTM airway (O) Ease and accuracy of insertion. Methods: An extensive literature search transpired by utilizing electronic databases: Hydi, Google Scholar, PubMed, EBSCO Host and Science Direct. Further search was done by going through all other similar studies found in the key studies’ reference lists. Expert local health professionals were contacted for enlightenment on local practices and possible retrieval of unpublished studies. Inclusion criteria used: English language studies, peer-reviewed, studies that were published in the last ten years focusing on adult patients requiring ventilation. Studies included were to compare cLMATM to i-gelTM intervention. The RCT critical appraisal tool was utilised on the 7 RCT’s chosen studies so to critically appraise the studies’ results veracity. No ethical issues were found amongst the key studies. Results: Results were inclined in answering the PICO question in favour of i-gelTM intervention. However, major inconsistencies were discovered upon evaluating the criteria assessed, consequently also the outcome results of the key studies. Implications and Recommendations: Further research, especially locally, is essential to confirm the best intervention to use. The need for more education to specialized health professionals and student anesthetists was discussed. Collaboration and participation of all stakeholders is essential for effective and successful educational programs. Conclusion: Although there is evidence supporting a preference in using the i-gelTM over the classic LMA, more thorough and extensive research is needed, especially in the local context, to answer the PICO question.