Key result
i-gel maintains ventilation and lowers peak airway pressure versus ETT in pediatric laparoscopic surgeries.
Why the study?
The current evidence on the safe use of supraglottic airway devices in pediatric laparoscopic surgeries is limited, and no studies have compared i-gel to endotracheal tube in this setting.
Does i-gel reduce peak airway pressure compared to endotracheal tube in pediatric patients undergoing elective laparoscopic surgeries?
RCT (n=60)
Single-blind
Randomly allocated
No
Does i-gel reduce peak airway pressure compared to endotracheal tube in pediatric patients undergoing elective laparoscopic surgeries?
p-value: p=<0.001
The i-gel supraglottic airway provides adequate ventilation with lower peak airway pressures and minimal hemodynamic changes compared to endotracheal tubes, making it a suitable alternative for pediatric laparoscopic surgeries.
Supports i-gel to minimize peak airway pressures in pediatric laparoscopy; extends RCT evidence for supraglottic airways as endotracheal alternatives.
Background: The current evidence on the safe use of supraglottic airway for pediatric laparoscopic surgeries is limited.Although i-gel has been successfully used in adult laparoscopic surgeries, to our knowledge, no studies have compared it to the endotracheal tube (ETT) in pediatric laparoscopic surgeries.This study evaluated the effectiveness of i-gel over ETT with regards to the respiratory and hemodynamic parameters during pediatric laparoscopic surgeries.Methods: A total of 60 pediatric patients undergoing elective laparoscopic surgeries were randomly allocated to either the i-gel or ETT groups.Anesthetics used included ketamine, sevoflurane, and rocuronium.The primary outcome measured was the peak airway pressure (PAP) and the secondary outcomes measured were leak fraction, endtidal CO 2 , respiratory rate, insertion time, heart rate, blood pressure and perioperative complications.Results: The PAP during surgeries was higher in the ETT group than in the i-gel group.There were no statistically significant differences in the leak fraction, end-tidal CO 2 , and respiratory rate.The i-gel group had a shorter insertion time compared with the ETT group.The changes in heart rate were comparable in both groups.However, systolic and diastolic pressures were higher in the ETT group following intubation, before and after the creation of pneumoperitoneum.The incidence of perioperative complications was similar in both groups.Conclusions: The i-gel provided adequate ventilation with lower PAP compared with ETT.In addition, it provided minimal hemodynamic changes compared with ETT.Therefore, the i-gel may provide a suitable alternative to ETT in pediatric laparoscopic surgeries.
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Hong et al. (2019) conducted an RCT in Pediatric laparoscopic surgeries (n=60). i-gel vs. Endotracheal tube (ETT) was evaluated on Peak airway pressure (PAP) (p=<0.001). The i-gel provided adequate ventilation with significantly lower peak airway pressure at all time points compared with the endotracheal tube in pediatric laparoscopic surgeries (P < 0.001).
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