i-gel Device Reduces Postop Throat Pain A Comparison of Postoperative Throat and Neck Complaints After the Use of the i-gel® and the La Premiere® Disposable Laryngeal Mask: A Double-Blinded, Randomized, Controlled Trial

Background: Throat complaints were common after the use of an endotracheal tube (ETT). Sore throat was also a common complaint after the use of a laryngeal mask (LM). After the introduction of i-gel®, which is a preformed siliconized non-inflatable LM, it was hypothesized that sore throat would be less. Objective: To compare the throat complaints postoperatively after general anesthesia with the use of either igel or La Premiere® LM. Methods: 244 patients were randomized prospectively into 2 groups of patients using either i-gel or La Premiere LM during elective nonthoracic or nonabdominal surgeries. General anesthesia was given using standard protocols with propofol, sufentanil, and desflurane. Size 4 of either device was used for patients weighing up to 90 kg, and size 5 was used for patients >90 kg. Time of insertion was measured from the maneuvering of the head to the insertion of the device for a maximum of 3 attempts. A standardized cuff volume was used to inflate the LM. A successful insertion was when no leak was heard and the capnography showed a square capnogram. The device was taken out at the end of the procedure, and the patient was shifted to PACU. The patients were interviewed with specific questions at the end of 1, 24, and 48 hours, either in the ward or at home. Results: 244 patients were randomized (i-gel group, n=111; LM group, n=107). There were not statistical differences between groups regarding number of attempts of insertions or failure to insert either device. The igel group had a higher mean leak pressure, better fiberoptic view, and shorter time to insertion compared with the LM group. There was a higher incidence of sore throat, neck pain, and dysphagia in the LM group. Conclusions/Discussion: The common postoperative throat complaints of dysphagia and sore throat were less in the i-gel group versus the La Premiere LM airway group. Because no other supraglottic device was compared, one cannot conclude that the incidence of throat complaints would be better. The limitation of this study was that a standardized cuff volume was used instead of using volume to a predetermined pressure. The incidence of throat complaints and sore throat could have been lower if standard inflation pressures of between 40 to 60 cm H2O were used. The other limitation was the variables of the device, which could lead to probable bias, thus concluding that i-gel had a lower incidence of postoperative throat complaints as compared to the La Premiere LM device. Reviewer's Comments: The i-gel is a preformed, non-inflatable laryngeal airway device which has decreased throat complaints as compared to the La Premiere LM airway. (Reviewer-Sunita Goel, MD).