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Minerva Anestesiologica 2021 October;87(10):1109-16

DOI: 10.23736/S0375-9393.21.15696-2

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

The effects of two-handed jaw thrust on i-gel™ placement in anesthetized non-paralyzed patients

Hyub HUH 1, Jang E. CHO 2, Suk W. LEE 2, Hyun-Chang KIM 3

1 Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Kangdong, Seoul, South Korea; 2 Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Korea University Anam Hospital, Seoul, South Korea; 3 Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea



BACKGROUND: I-gelTM is a second-generation supraglottic airway device with a non-inflatable cuff. In this prospective randomized investigation, we evaluated the effects of two-handed jaw thrust technique on i-gel insertion in anesthetized non-paralyzed patients.
METHODS: Seventy-four adult patients were allocated to two groups (N.=37 each). In the jaw thrust group, two-handed jaw thrust technique was applied to facilitate i-gel insertion. In the control group, conventional i-gel insertion was performed. The success rate at the first attempt, air leakage pressure, insertion time, and postoperative sore throat incidence were recorded.
RESULTS: The success rate at the first attempt was higher in the jaw thrust group (37 [100%] vs. 31 [84%], difference of 16%, 95% confidence interval for the difference: 1 to 33%, P=0.03). The median air leakage pressure was higher in the jaw thrust group than in the control group (20 [interquartile range 13] vs. 17 [interquartile range 3] cmH2O, difference: 6, 95% confidence interval of the difference: 3 to 8, P<0.01). The mean insertion time was shorter in the jaw thrust group (27±14 vs. 41±29 seconds, difference: 14 seconds, 95% confidence interval of the difference: 3 to 24, P=0.01). The incidence of postoperative sore throat at the postoperative one hour was lower in the jaw thrust group (seven [20%] vs. 15 [41%], difference 22%, 95% confidence interval for the difference: -1 to 42%, P=0.04).
CONCLUSIONS: The two-handed jaw thrust technique facilitated i-gel insertion compared to the conventional technique in anesthetized non-paralyzed patients.


KEY WORDS: Laryngeal masks; Airway management; Supraglottitis; Anesthesia, general

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