Jemds.com Review Article J. Evolution Med. Dent. Sci./eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 6/ Issue 66/ Aug. 17, 2017 Page 4779 I-GEL AS AN AIRWAY DEVICE- A PROSPECTIVE STUDY IN 30 PLASTIC SURGICAL PATIENTS Aniruddha Nirkhi 1 , Ketaki Patwardhan 2 , Vijay Patil 3 1 Consultant Cardiac Anaesthetist, Bombay Hospital, Mumbai. 2 Associate Professor, Department of Anaesthesia, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Kalwa, Thane. 3 Associate Professor, Department of Anaesthesia, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Kalwa, Thane. ABSTRACT BACKGROUND Supraglottic airway devices have become invaluable for both routine and difficult airway management. After the introduction of the laryngeal mask airway LMA-Classic in the 1980s, there has been a steady increase in the applications for use of supraglottic airways as well as incidence of use. I-gel is an innovative supraglottic airway device. Made from a medical grade thermoplastic elastomer, I- gel has been designed to create a non-inflatable, anatomical seal of the pharyngeal, laryngeal and perilaryngeal structures whilst avoiding compression trauma. The aim of this study is to determine the ease of insertion, adequacy of ventilation upon insertion, the haemodynamic stability during and after insertion and postoperative complications occurring due to I-gel insertion. MATERIALS AND METHODS We conducted a prospective randomised study on I-gel TM (Intersurgical Ltd, Wokingham, UK) on 30 plastic surgical patients of ASA physical status I-II. After premedication with midazolam and fentanyl, induction was done with Propofol and I-gel was inserted according to manufacturer’s instruction. 1 An effective airway was confirmed by bilateral chest movement, square wave on capnograph and SpO2>95%. RESULTS The study shows that I-gel has many advantages, including ease of insertion, higher success rate on first attempt of insertion, effective airway maintenance, ease of gastric tube insertion, less number of failures and lesser complications intraoperatively as well as postoperatively. CONCLUSION I-gel is a simple, excellent and easy-to-use supraglottic airway device, easy to insert without the need of many manipulations with maintenance of airway. KEYWORDS Supraglottic, I-gel, Airway, Haemodynamic. HOW TO CITE THIS ARTICLE: Nirkhi A, Patwardhan K, Patil V. I-gel as an airway device- A prospective study in 30 plastic surgical patients. J. Evolution Med. Dent. Sci. 2017;6(66):4779-4782, DOI: 10.14260/Jemds/2017/1035 BACKGROUND Since 1983 there was no update on the cuffed supraglottic airway devices, which is introduced blindly into the hypopharynx to form a seal around the larynx, so permitting spontaneous or positive pressure ventilation without penetration of the larynx or oesophagus. It was used in place of the facemask in routine anaesthesia, and where difficulties with the airway were expected. 1 Supraglottic airway devices are developed with increasing frequency following the overwhelming success of the laryngeal mask airway (LMA). The LMA and similar supraglottic airway devices use an inflatable cuff to wedge into the upper oesophagus and provide a perilaryngeal seal. 2 Financial or Other, Competing Interest: None. Submission 21-06-2017, Peer Review 06-08-2017, Acceptance 12-08-2017, Published 17-08-2017. Corresponding Author: Dr. Ketaki Patwardhan, Flat No. 1C, Angel Apartment, Cosmos Springs 2, Ovala, Ghodbunder Road, Thane. E-mail: ketaki_p18@yahoo.co.in DOI: 10.14260/jemds/2017/1035 One of the most limiting features of the LMA is a lack of airway protection from regurgitated gastric contents, controversy surrounds the theory that the presence of the LMA in the pharynx could promote regurgitation by reducing lower oesophageal sphincter tone. 3 I-gel TM (Intersurgical Ltd, Wokingham, U.K.) is a new supraglottic airway device with anatomically designed, non- inflatable mask, which is soft, gel like and transparent, made of thermoplastic elastomer. The soft, non-inflatable cuff fits snugly onto the perilaryngeal framework and its tip lies in the proximal opening of the oesophagus, isolating the oropharyngeal opening from the laryngeal inlet. The outer cuff shape ensures that the blood flow to the laryngeal and perilaryngeal framework is maintained and helps the possibility to reduce neurovascular compression trauma to the nerves. The device has buccal cavity stabiliser which has propensity to adopt its shape to oropharyngeal curvature of the patients. It is anatomically widened and concaved to eliminate the potential for rotation, thereby reducing the risk of malposition. This buccal cavity stabiliser houses airway tubing and separate gastric channel. The tube section is firmer than the soft bowl of the gastric channel. The firmness of tube section and its natural oropharyngeal curvature allows the