Insertion of i-gel™ by the reversed technique improves the success rate and reduces the time taken for its placement: A prospective, randomized, controlled, interventional trial

BACKGROUND AND AIMS We hypothesized that the i-gel™ supra-glottic airway can be inserted with relative ease in a reversed manner just like a Guedel's airway. MATERIAL AND METHODS A prospective, randomized, controlled interventional trial was conducted on 100 patients to compare reversed insertion of the i-gel™ (Group R) with the conventional insertion (Group C). In Group C, i-gel™ was introduced in a conventional manner, whereas in the Group R, i-gel™ was introduced into the oral cavity with the concavity facing the hard palate. On reaching the oropharynx, the device was rotated 180° and advanced further until it fitted over the larynx. The time of insertion, ease, and placement appropriateness were compared. RESULTS All patients completed the study. Better success rate of the first attempt insertion was achieved using the reversed technique (96% vs. 86%), but it was not statistically significant. Mean time required for i-gel™ insertion in Group R was 17.5 ± 6.9 s as compared to 20.8 ± 5.9 s in Group C, which was statistically significant. In Group R, it could be inserted within 20 s in 84% of cases, but only in 62% in Group C. The seal of the i-gel™ was similar in both the groups with the leak volumes (inspired - expired tidal volumes) being similar. CONCLUSION Reversed insertion technique for the placement of i-gel™ resulted in appropriate placement with easier insertion and lower placement time than that with the conventional technique.