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Modified jaw thrust I-gel insertion technique in adults: a case series

BACKGROUND: The I-gel is a second-generation supraglottic airway device that is built with a noninflatable elliptical gel material cuff and has a wide semirigid stem. The I-gel supralaryngeal seal has shown promising efficacy for both spontaneous and controlled ventilation under general anesthesia....

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Autor principal: Kumar, Dileep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254558/
https://www.ncbi.nlm.nih.gov/pubmed/35787820
http://dx.doi.org/10.1186/s13256-022-03482-9
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author Kumar, Dileep
author_facet Kumar, Dileep
author_sort Kumar, Dileep
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description BACKGROUND: The I-gel is a second-generation supraglottic airway device that is built with a noninflatable elliptical gel material cuff and has a wide semirigid stem. The I-gel supralaryngeal seal has shown promising efficacy for both spontaneous and controlled ventilation under general anesthesia. The recommended, standard I-gel insertion technique is relatively challenging due to its shape and cuff size. Usually, the I-gel becomes entrapped at the oral cavity and requires excessive force to negotiate across the oropharynx, resulting in insertion resistance, tongue obstruction, insertion failure, and intraoral trauma. This case series evaluated a modified jaw thrust I-gel insertion technique because it is claimed to allow smooth and atraumatic I-gel placement in adults. CASE PRESENTATION: In this case series, ten male and female Indo-Aryan group of Asian patients aged 18–60 years were recruited for I-gel device placement through a modified jaw thrust technique for short to intermediate surgical duration in below-umbilical surgical procedures. Patient consent was obtained, and baseline vital signs such as electrocardiogram, noninvasive blood pressure, and peripheral oxygen saturation readings were recorded. Following preoxygenation, propofol 2 mg/kg was administered for anesthesia induction and nalbuphine 0.1 mg/kg for analgesia. In all patients, an I-gel was placed by the modified jaw thrust technique. The patient’s demographics, number of attempts, I-gel insertion resistance, and insertion time duration were recorded. CONCLUSION: The findings showed a 100% first-attempt insertion rate along with negligible insertion resistance and convincing insertion time duration with modified jaw thrust I-gel insertion technique. However, a blood-stained I-gel was observed in one male patient at the time of removal. The patient’s demographics such as age, weight, American Society of Anesthesiologists status, and surgical and anesthesia duration were found not to be significant. The modified jaw thrust I-gel insertion technique could be considered as an alternative in adults when difficulty is encountered with the standard I-gel insertion technique.
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spelling pubmed-92545582022-07-06 Modified jaw thrust I-gel insertion technique in adults: a case series Kumar, Dileep J Med Case Rep Case Report BACKGROUND: The I-gel is a second-generation supraglottic airway device that is built with a noninflatable elliptical gel material cuff and has a wide semirigid stem. The I-gel supralaryngeal seal has shown promising efficacy for both spontaneous and controlled ventilation under general anesthesia. The recommended, standard I-gel insertion technique is relatively challenging due to its shape and cuff size. Usually, the I-gel becomes entrapped at the oral cavity and requires excessive force to negotiate across the oropharynx, resulting in insertion resistance, tongue obstruction, insertion failure, and intraoral trauma. This case series evaluated a modified jaw thrust I-gel insertion technique because it is claimed to allow smooth and atraumatic I-gel placement in adults. CASE PRESENTATION: In this case series, ten male and female Indo-Aryan group of Asian patients aged 18–60 years were recruited for I-gel device placement through a modified jaw thrust technique for short to intermediate surgical duration in below-umbilical surgical procedures. Patient consent was obtained, and baseline vital signs such as electrocardiogram, noninvasive blood pressure, and peripheral oxygen saturation readings were recorded. Following preoxygenation, propofol 2 mg/kg was administered for anesthesia induction and nalbuphine 0.1 mg/kg for analgesia. In all patients, an I-gel was placed by the modified jaw thrust technique. The patient’s demographics, number of attempts, I-gel insertion resistance, and insertion time duration were recorded. CONCLUSION: The findings showed a 100% first-attempt insertion rate along with negligible insertion resistance and convincing insertion time duration with modified jaw thrust I-gel insertion technique. However, a blood-stained I-gel was observed in one male patient at the time of removal. The patient’s demographics such as age, weight, American Society of Anesthesiologists status, and surgical and anesthesia duration were found not to be significant. The modified jaw thrust I-gel insertion technique could be considered as an alternative in adults when difficulty is encountered with the standard I-gel insertion technique. BioMed Central 2022-07-05 /pmc/articles/PMC9254558/ /pubmed/35787820 http://dx.doi.org/10.1186/s13256-022-03482-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Kumar, Dileep
Modified jaw thrust I-gel insertion technique in adults: a case series
title Modified jaw thrust I-gel insertion technique in adults: a case series
title_full Modified jaw thrust I-gel insertion technique in adults: a case series
title_fullStr Modified jaw thrust I-gel insertion technique in adults: a case series
title_full_unstemmed Modified jaw thrust I-gel insertion technique in adults: a case series
title_short Modified jaw thrust I-gel insertion technique in adults: a case series
title_sort modified jaw thrust i-gel insertion technique in adults: a case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254558/
https://www.ncbi.nlm.nih.gov/pubmed/35787820
http://dx.doi.org/10.1186/s13256-022-03482-9
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