Comparative Evaluation of I-Gel with Uncuffed Endotracheal Tube for Adequacy of Ventilation in Elective Paediatric Surgeries

Abstract

Background: Uncuffed endotracheal tubes (ETTs) are standard of care for airway management in children up to eight years of age. Direct Laryngoscopy and endotracheal intubation are invasive techniques which may cause hemodynamic changes and can give rise to airway complication. Supraglottic airway devices have been introduced since the past few decades for the management of airway in both adults and children. I-Gel, a second generation supraglottic airway device, is used frequently for securing airway for children.
 Methods: Total of 90 children of age 2-8 years of age were randomized into two groups, 45 children were ventilated with I-Gel and remaining 45 were ventilated with an uncuffed ETT. Ventilatory parameters like oropharyngeal leak, peak airway pressure and airway sealing quality (ASQ) score were monitored intraoperatively and possible complications were observed at a timely interval after removal of device.
 Results: Mean oropharyngeal leak pressure in the I-Gel and uncuffed ETT group observed were 20 cmH2O and 19.56 cmH2O respectively. ASQ score was comparable in both groups. Ten patients in the I-Gel group while two in the uncuffed ETT group had blood staining of the device after removal and the difference was statistically significant. Incidence of cough and sore throat post-extubation and after six hours was significantly higher in the ETT group as compared to the I-Gel group.
 Conclusion: Both devices were comparable and equally effective for adequacy of ventilation while blood staining of the device was observed in the I-Gel group however, cough and sore throat were observed in the ETT group.