Evaluation of i-gel(™) airway in children: a meta-analysis

Background: I-gel(™) is a relatively newer addition in the pediatric anesthesia practice. Its comparison with the other laryngeal mask airway repor-ted a wide range of results. Randomized controlled trials where i-gel(™) has been compared with other laryngeal masks (laryngeal mask airway ProSeal(™) and laryngeal mask airway Classic(™) ) in children for airway management device during general anesthesia has been included in this meta-analysis.

Methods: PubMed and Central Register of Clinical Trials of the Cochrane Collaboration for eligible controlled trials using following search words: 'i-gel', 'i-gel laryngeal mask airway', 'i-gel children', 'i-gel paediatric' until February 15, 2014. A total nine prospective randomized controlled trials have been included in this meta-analysis.

Results: Pooled analyses have found that i-gel(™) provided significantly higher oropharyngeal leak pressure than laryngeal mask airway ProSeal(™) [496 participants, mean difference 2.07 cm H2 O, 95% CI 0.52-3.62; P = 0.009] and a similar leak in comparison with laryngeal mask airway Classic(™) [355 participants, mean difference 1.73 cm H2 O, 95% CI -0.04, 3.51 cm H2 O; P =0.06]. No difference was found in first insertion success rate and ease of insertion between i-gel(™) , laryngeal mask airway ProSeal(™) , and laryngeal mask airway Classic(™) . Ease of gastric tube insertion is similar between i-gel(™) and laryngeal mask airway ProSeal(™) . Reported complications are infrequent and similar in all three devices.

Conclusion: We conclude that i-gel(™) is an effective alternative of the commonly used laryngeal mask airway ProSeal(™) and laryngeal mask airway Classic(™) in children for airway management during general anesthesia.