A Comparative Study Regarding the Haemodynamic Stress Response and Efficacy of Endotracheal Intubation and i-gel Insertion During Infraumbilical Surgery

Author(s): Amalendu Bikas Chatterjee1 , Kuntal Malik2 , Pronobesh Ganguly3 , Debanjana Roy4

BACKGROUND Endotracheal Intubation is the Gold Standard for maintenance of airway, but it has several complexities. Deleterious haemodynamic consequences may occur during intubation due to reflex sympathoadrenal stimulation. i-gel is a new single use, non-inflatable supraglottic airway device being used in anaesthesia during spontaneous or intermittent positive pressure ventilation. The aim of the study was to compare the clinical efficacy and complications of i-gel with standard endotracheal tube during general anaesthesia. METHODS One hundred healthy adult patients undergoing elective infraumbilical surgery were randomly included by computer generated randomization into two groups, Group E: Endotracheal tube and Group: I i-gel. Uniform premedication drugs, induction agents, muscle relaxants and anaesthesia technique were used in both groups of patients. Haemodynamic parameters like heart rate, blood pressure, SpO2, ETCO2 were recorded after induction, immediately after intubation and at 1, 3, 5, 10 min after intubation. Ease of insertion, time taken for placement of device, insertion attempts, attempts at gastric tube insertion and any airway trauma were also noted for comparison. RESULTS Increase in mean Heart Rate, Blood Pressure and ETCO2 were relatively less in igel group when compared with group E at different time intervals immediately after Intubation. Ease of insertion and number of attempts had no statistical significance, but time taken for insertion of i-gel was significantly less than endotracheal tube. CONCLUSIONS i-gel is an effective and safe alternative to endotracheal tube for airway management and it takes less time to insert and causes less haemodynamic perturbations.