Anesthésie et recherche clinique
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Can i-gel Replace Endotracheal Tube during Elective Cesarean Section?

Sabry Amin and Sameth Fathy

Background: General anesthesia with endotracheal tube and rapid sequence induction remain the gold standard for caesarean section. The I-gel is supraglottic airway devices it provides a better seal for positive pressure ventilation, separation of the respiratory from the alimentary tract and the venting of gas or liquid via its unique drain port. The aim of our study was to evaluate the efficacy of I-gel as rescue device in rapid establishment of airway and protect against pulmonary aspiration during elective CS under general anesthesia.

Patients and Methods: This study was conducted on 1000 parturients with at least eight hours of fasting scheduled for elective Cesarean delivery. We recorded the number of insertion attempts of the i-gel, the time to effective ventilation, incidence of aspiration, the presence of blood on the I gel, postoperative sore throat, and patients and obstetricians satisfaction.

Result: 1000 parturients, were included, mean body mass index was 28.5±3.4 (kg/m²). All i-gel insertions were successful on first attempt in (99%) of the cases and a time to effective airway of 11.3±2.4 sec. There was no evidence of regurge or aspiration. 25 parturients (2.5%) had visible blood on the i-gel upon removal, 20 (2%) had sore throat, one patients (0.1%) had tingling in the tongue and patients and obstetricians satisfaction was 98%.

Conclusion: The i-gel is useful supraglottic device and can replace the need of tracheal intubation in elective cesarean section with no reported serious complications and low incidences of pharyngolaryngeal morbidity when compared to tracheal intubation.