• İlkay Baran Akkuş, Fatma Kavak Akelma, Merve Emlek, Derya Özkan, Jülide Ergil, and Reyhan Polat.
• Department of Anesthesiology and Reanimation, University of Health Sciences, Diskapi Yildirim Beyazit Trainig and Research Hospital, Sehit Ömer Halisdemir Str, 06110, Dıskapı- Altındag, Ankara, Turkey. ilkayb@hotmail.com.
• J Anesth. 2020 Aug 1; 34 (4): 512-518.

PurposeThe i-gel is a supraglottic airway device with non-inflatable cuff which can suffer insertion failure if its standard placement technique is implemented. The aim of this study was to compare the placement technique proposed by the manufacturer of i-gel with the triple airway maneuver in terms of successful device insertion time and first-attempt success.MethodsAfter ethics committee approval, 103 ASA I-III patients were randomly allocated to the standard or triple airway maneuver groups. In the standard Group, the i-gel was inserted in the sniffing position while, in the triple group, it was inserted using the triple airway maneuver consisting of head tilt, jaw thrust, and open mouth. The time taken for successful insertion, first-attempt success rate, i-gel position, airway complications, and hemodynamic responses were assessed.ResultsBetween the two groups patient characteristics were similar. Time for successful insertion was significantly shorter in the triple group (20 ± 7 s) than with the standard technique (32 ± 11 s; p < 0.001). Successful insertion at the first attempt was 78% and 92% for the standard and triple group, respectively (p = 0.092). The i-gel position, airway complications, and hemodynamic responses were similar in both groups.ConclusionThe triple airway maneuver required less i-gel insertion time as compared with the standard placement technique. First-attempt success rates were similar with both techniques, although the triple airway maneuver was superior to the standard method as a rescue technique in failed insertions. We therefore recommend use of the triple airway maneuver in i-gel insertion.

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