Comparison of the i-gel and the laryngeal mask airway proseal during general anesthesia: a systematic review and meta-analysis

• Published in: PloS one 2015-03, Vol.10 (3), p.e0119469-e0119469
• Main Authors: Park, Sun Kyung, Choi, Geun Joo, Choi, Yun Suk, Ahn, Eun Jin, Kang, Hyun
• Format: Article
• Language: English
• Subjects: Adults; Airway management; Analysis; Anesthesia; Anesthesia, General - adverse effects; Anesthesia, General - methods; Anesthesiology; Bias; Blood; Clinical trials; Collaboration; Complications; Confidence intervals; Dysphagia; Fiber optic equipment; Gynecology; Humans; Insertion; Laryngeal Masks - adverse effects; Medical research; Medicine; Meta-analysis; Pain; Pharyngitis; Pharynx; Randomization; Regression analysis; Respiratory tract; Scientific papers; Search engines; Staining; Statistical analysis; Studies; Success; Surgery; Systematic review
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0119469

Conflicting results have been reported for the i-gel and the laryngeal mask airway proseal (LMA-P) during general anesthesia. The objective of the current investigation was to compare the efficacy and safety of the i-gel vs. the LMA-P during general anesthesia. Two authors performed searches of MEDLINE, EMBASE, CENTRAL, and Google Scholar to identify randomized clinical trials that compared the LMA-P with the i-gel during general anesthesia. A meta -analysis was performed using both random and fixed-effect models. Publication bias was evaluated using Begg's funnel plot and Egger's linear regression test. Twelve randomized clinical trials met the eligibility criteria. There were no significant differences in insertion success rate at the first attempt (risk ratio [RR] 1.01, 95% confidence interval [CI] 0.97, 1.06), ease of insertion (RR 1.14, 95% CI 0.93, 1.39), oropharyngeal leak pressure (OLP) (MD -1.98, 95% CI -5.41, 1.45), quality of fiberoptic view (RR 1.00, 95% CI 0.91, 1.10) and success rate of gastric tube insertion (RR 1.07, 95% CI 0.98, 1.18) between the i-gel and the LMA-P, respectively. The i-gel had a shorter insertion time than the LMA-P (MD -3.99, 95% CI -7.13, -0.84) and a lower incidence of blood staining on the device (RR 0.26, 95% CI 0.14, 0.49), sore throat (RR 0.28, 95% CI 0.15, 0.50) and dysphagia (RR 0.27, 95% CI 0.10, 0.74). Both devices were comparable in ease of insertion to insert and both had sufficient OLP to provide a reliable airway. Only a few minor complications were reported. The i-gel was found to have fewer complications (blood staining, sore throat, dysphagia) than the LMA-P and offers certain advantages over the LMA-P in adults under general anesthesia.