A comparison of clinical performance between i-gel and endotracheal tube in pediatric laparoscopic surgeries

摘要

Background: The current evidence on the safe use of supraglottic airway for pediatric laparoscopic surgeries is limited. Although i-gel has been successfully used in adult laparoscopic surgeries, to our knowledge, no studies have compared it to the endotracheal tube (ETT) in pediatric laparoscopic surgeries. This study evaluated the effectiveness of i-gel over ETT with regards to the respiratory and hemodynamic parameters during pediatric laparoscopic surgeries. Methods: A total of 60 pediatric patients undergoing elective laparoscopic surgeries were randomly allocated to either the i-gel or ETT groups. Anesthetics used included ketamine, sevoflurane, and rocuronium. The primary outcome measured was the peak airway pressure (PAP) and the secondary outcomes measured were leak fraction, end-tidal COsub2/sub, respiratory rate, insertion time, heart rate, blood pressure and perioperative complications. Results: The PAP during surgeries was higher in the ETT group than in the i-gel group. There were no statistically significant differences in the leak fraction, end-tidal COsub2/sub, and respiratory rate. The i-gel group had a shorter insertion time compared with the ETT group. The changes in heart rate were comparable in both groups. However, systolic and diastolic pressures were higher in the ETT group following intubation, before and after the creation of pneumoperitoneum. The incidence of perioperative complications was similar in both groups. Conclusions: The i-gel provided adequate ventilation with lower PAP compared with ETT. In addition, it provided minimal hemodynamic changes compared with ETT. Therefore, the i-gel may provide a suitable alternative to ETT in pediatric laparoscopic surgeries.