Randomized trial comparing the i-gel™ and Magill tracheal tube with the single-use ILMA™ and ILMA™ tracheal tube for fibreoptic-guided intubation in anaesthetized patients with a predicted difficult airway

Background. The i-gel TM is a single-use supraglottic airway device (SAD) that allows fibreoptic-guided tracheal intubation through the device. Until now, no prospective data for this procedure are available. Therefore, in a prospective randomized controlled trial, we evaluated fibreoptic-guided tracheal intubation with a standard Rusch TM PVC tracheal tube (TT) through the i-gel TM compared with the single-use ILMA TM (sILMA TM ) TT through the sILMA TM in patients with a predicted difficult airway. Methods. With ethics committee approval and written informed consent, 160 patients were randomly assigned to either SAD. After placement of the SAD, a fibreoptic bronchoscope was introduced into the trachea as a railroad for the TT. Primary outcome variable was the first-attempt fibreoptic-guided intubation success rate. Secondary variables included time for insertion and intubation, airway leak pressures, fibreoptic view, and adverse events. Data are presented as mean (SD) or percentages. A P-value of ,0.05 was considered statistically significant. Results. Fibreoptic-guided intubation was successful at the first attempt in 76 patients (96%) using the i-gel TM and in 71 patients (90%) using the sILMA TM (P¼0.21). Most of the failed intubations were rescued by conventional laryngoscopy. Airway leak pressure was higher for the sILMA TM . There were no problems during removal of either type of SAD. Conclusions. Fibreopic-guided tracheal intubation through the i-gel TM using a standard Rusch TM Magill TT is successful and an alternative to the sILMA TM with the sILMA TM TT.