COMPARISON OF I-GEL AND LARYNGEAL MASK AIRWAY IN PATIENTS UNDERGOING SHORT GYNAECOLOGICAL PROCEDURES: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background:  Supraglottic airway devices (SADs) such as the i-gel (a cuffless, gel-based single-use device) and the laryngeal mask airway (LMA) (commonly the Classic or ProSeal variants with an inflatable cuff) have become popular alternatives to endotracheal intubation for short surgical procedures under general anesthesia, offering advantages like easier insertion, reduced airway trauma, hemodynamic stability, and suitability for spontaneous or controlled ventilation in low-risk patients.

Objectives: This randomized controlled trial aimed to compare the outcomes of i-gel versus LMA in terms of insertion time and ease of insertion in patients undergoing short gynaecological procedures.

Methods: Seventy female patients, aged 18-60 years, ASA class I-II, and scheduled for procedures lasting ≤30 minutes were enrolled. Patients were randomly divided into two groups: Group I (i-gel, n=35) and Group L (LMA, n=35). Premedication included midazolam 0.03 mg/kg and ranitidine 50 mg IV. Anaesthesia was induced with propofol 2 mg/kg, and the assigned device was inserted. Insertion time was recorded from device pickup to attachment to the breathing circuit, and ease was classified as easy (1-2 attempts) or poor (>2 attempts).

Results: The mean insertion time was 14.23 ± 1.75 seconds for i-gel and 26.03 ± 3.03 seconds for LMA (p<0.001). Ease of insertion was better with i-gel, with 97.14% easy insertions compared to 80% for LMA (p=0.024). Stratification by age and BMI showed no significant impact on ease (p>0.05). No major complications were observed in either group.

Conclusion: The i-gel demonstrated superior performance with shorter insertion time and greater ease, making it a preferable choice for short gynecological procedures under general anaesthesia. This supports previous findings on SADs in similar settings. Further studies could explore long-term outcomes and cost-effectiveness.