COMPARISON OF THE I-GEL WITH THE CUFFED TRACHEAL TUBE IN GYNECOLOGICAL LAPAROSCOPIC SURGERY DURING PRESSURE-CONTROLLED VENTILATION

Background. Laparoscopy is one of the most common surgical procedures performed by gynecologists. Although the ideal role of laparoscopy in gynecologic surgery continues to be defined, it has become a standard approach for a numerous gynecologic procedures. The i-gel is a novel device that differs from other supraglottic airway devices in that it has a softer and a non-infatable cuff. Our study was assess whether the i-gel is suitable to provide pressure-controlled ventilation (PCV) during anesthesia in laparoscopic surgery by measuring the gas leaks and comparing these values with that of the tracheal tube.

Methods. 58 female patients (ASA I–II, 18–75 years) undergoing elective gynecological laparoscopic surgery in the lithotomy position were studied. Patients were allocated into two groups: airway management in one group was conducted with a tracheal tube (n=29), and in the other one — with an i-gel (n=29). The lungs were then ventilated using PCV (15 mm H2O). The difference between the inspired and expired tidal volumes was used to calculate the leak volume. The leak fraction was defined as the leak volume divided by the inspired tidal volume.

Results. There was no significant difference between the leak fractions of the i-gel and the tracheal tube at 15 mm H2O PCV.

Conclusions. We suggest that the i-gel can be used as a reasonable alternative to tracheal tube in gynecological laparoscopic surgery during PCV with moderate airway pressures.