Comparative Study of I-GEL and Endotracheal Tube in Elective Laparoscopic Gynecological Surgeries under General Anesthesia

Abstract

Introduction: Laparoscopic procedures have become the need of the hour. Pneumoperitoneum and positional variations in laparoscopy causes alterations in hemodynamic and ventilatory parameters, which results in making the task of anesthesiologist more challenging. Endotracheal tube (ETT) has been the gold standard for induction of general anesthesia but the newer supraglottic airway devices (SADs) (LMA, I-Gel) has increased the armamentarium of anesthesiologists. Our main aim was to compare I-Gel and endotracheal Tube and to consider I-Gel as safe and effective alternative to endotracheal tube for general anesthesia in elective laparoscopic surgeries. Materials and Methods: It was a comparative prospective randomized study conducted on 128 patients (ASA I/II) after consent from institutional ethical committee. Patients were divided in two groups 64 each. Group A induced with I-Gel without muscle relaxant and Group B with endotracheal tube after laryngoscopy and muscle relaxant. Alterations in pulse rate, blood pressure were noted down and ease and time of insertion were compared. Results: The ease of insertion and the attempts of insertion were comparable but the time of insertion was less with I-Gel with results being statistically significant. The rise in hemodynamic parameters from baseline was more in endotracheal tube intubated patients and so was the incidence of postoperative complications. Conclusion: We concluded that I-Gel requires less time for insertion with minimal hemodynamic changes in comparison to endotracheal tube. I-Gel also provided adequate positive-pressure ventilation, comparable with endotracheal tube. Thus I-Gel can be considered safe and suitable alternative to endotracheal tube for laparoscopic surgeries.