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I Gel Versus Endotracheal Tube for Pediatric day Care Surgeries

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Background: The I-gel TM (Intersurgical, Wokingham, UK) is a novel second generation supraglottic airway device with a non inflatable cuff, made up of a unique soft gel like material (Styrene Ethylene Butadiene Styrene). The device is transparent and latex free. It is easy to insert and has minimal tissue compression. An integrated gastricchannel is provided for passage of gastric drainage tube to empty the stomach. Objectives: The aim of the present study wasto compare the efficacy of I-gel with Endotracheal tube in airway management in children. Materials and methods: This study was conducted at tertiary referral centre for new born and children with Children of age 2 to 6 years, weighing 10 to 18 kg, ASA Grade I-II posted for elective day care procedures. Results: Males were predominant in both the groups. Insertion and ease of placement was successful in first attempt in 86.66% of patients in Group I as compared to 80% in Group II (ET). 13.33% of patients in Group I (3 out of 30) required adjustment like jaw thrust, neck extension or reinsertion because of forward displacement. One patient had been recorded in Group I (I- gel) as failure because of inadequate ventilation and required endotracheal intubation. 20% in Group II required second attempt for ET tube placement because of early learning curve of anaesthesia trainees in the teaching institute. There was a significant rise in HR & BP in Group II during laryngoscopy and intubation and at the time of extubation. Airway related adverse events (coughing, breathholding, laryngospasm) were more in Group II when compared to Group I. Conclusion: The I-gel is ease of insertion, success rates, minimal hemodynamic perturbations and minimum perioperative adverse effects.

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Background: The I-gel TM (Intersurgical, Wokingham, UK) is a novel second generation supraglottic airway device with a non inflatable cuff, made up of a unique soft gel like material (Styrene Ethylene Butadiene Styrene). The device is transparent and latex free. It is easy to insert and has minimal tissue compression. An integrated gastricchannel is provided for passage of gastric drainage tube to empty the stomach. Objectives: The aim of the present study wasto compare the efficacy of I-gel with Endotracheal tube in airway management in children. Materials and methods: This study was conducted at tertiary referral centre for new born and children with Children of age 2 to 6 years, weighing 10 to 18 kg, ASA Grade I-II posted for elective day care procedures. Results: Males were predominant in both the groups. Insertion and ease of placement was successful in first attempt in 86.66% of patients in Group I as compared to 80% in Group II (ET). 13.33% of patients in Group I (3 out of 30) required adjustment like jaw thrust, neck extension or reinsertion because of forward displacement. One patient had been recorded in Group I (I- gel) as failure because of inadequate ventilation and required endotracheal intubation. 20% in Group II required second attempt for ET tube placement because of early learning curve of anaesthesia trainees in the teaching institute. There was a significant rise in HR & BP in Group II during laryngoscopy and intubation and at the time of extubation. Airway related adverse events (coughing, breathholding, laryngospasm) were more in Group II when compared to Group I. Conclusion: The I-gel is ease of insertion, success rates, minimal hemodynamic perturbations and minimum perioperative adverse effects.

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This page is a summary of: I Gel Versus Endotracheal Tube for Pediatric day Care Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6119.22.
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