Comparison of Success Rate of Three Different Techniques of I-Gel Insertion I.E. Standard, Rotational, Triple Airway Maneuver in Anaesthetized Paralyzed Adults -A Prospective Randomized Trial

Background: The present study was aimed to compare the success rate of three different techniques of I-Gel insertion i.e. standard, rotational, triple airway manoeuvre in anaesthetised paralysed adults. Materials and Methods: A total of 150 patients were included in this Prospective Randomised Trial at Department of Anaesthesia, Dr. R.P.G.M.C. Kangra at Tanda during the study period. The patients were divided into 3 groups with 50 patients each. The patients in group A included standard technique, group B with rotational technique and group C included triple airway manoeuvre. The primary endpoint of this investigation was the first attempt insertion success rate. The secondary endpoints were insertion time, number of attempts. Results: In our study, in standard group first attempt success rate was 86 % and second attempt success rate was 14%. In rotational group, first attempt success rate was 96% and 4% in second attempt and lastly triple airway manoeuvre group first attempt success rate was 94% and 6% in second attempt. Though success rate was higher in rotational and triple airway group than standard group, there was no significant difference of success rate distribution between three groups (P=0.149). Hence all the three groups were comparable for first attempt success rate. Number of insertion attempts were significantly higher in standard group in comparison to rotational group (1.3±0.46 vs. 1.04±0.19; P<0.0001) and triple airway manoeuvre group (1.3±0.46 vs. 1.06±0.24; P=0.001). In our study, insertion time in standard group was 11.76±4.92 sec, in rotational group was 10.42±2.89 sec and 8.50±2.44 sec in triple airway manoeuvre group. On comparison, insertion time was significantly shorter in triple airway manoeuvre group in comparison to standard group (8.50±2.44 sec vs 11.76±4.92 sec; P<0.0001) and significantly shorter in comparison with rotational group (8.50±2.44 sec vs 10.42±2.89 sec; P=0.027). Conclusion: The triple airway maneuver technique shows higher overall success rate in first attempt of insertion, shorter insertion time, lesser insertion attempts in comparison to rotational and standard techniques of I-Gel insertion.