Muscle relaxant facilitates i-gel insertion by novice doctors: A prospective randomized controlled trial

J Clin Anesth. 2016 Sep:33:218-22. doi: 10.1016/j.jclinane.2016.03.058. Epub 2016 May 4.

Abstract

Study objective: This study aimed to determine whether muscle relaxants facilitates insertion efficacy of the i-gel supraglottic device (i-gel) by novice doctors in anesthetized patients.

Design: Randomized clinical trial.

Setting: Operating room.

Patients: Seventy adult patients scheduled for elective surgery under general anesthesia.

Interventions: Seventy adult patients were assigned to the rocuronium (MR group; 35 patients) or control group (C group; 35 patients). Anesthesia was induced with propofol and remifentanil, and 0.9mgkg(-1) rocuronium was administered in the MR group.

Measurements: The number of attempts to successful insertion, sealing pressure, and subjective difficulty of insertion were compared between the groups.

Main results: The total number of insertion attempts were as follows: one (MR group, 17 cases; C group, 4 cases), two (MR group, 13 cases; C group, 14 cases), three (MR group, 4 cases; C group, 14 cases), and failure (MR group, 1 case; C group, 3 cases), which was significantly different (P<.001). Sealing pressure was significantly higher in the MR group than in the C group (MR group, 22.1±5.4 cmH2O; C group, 18.7±3.2 cmH2O, P<.001). Subjective difficulty of insertion was significantly lower in the MR group than in the C group (C group, 72.4±19.0mm; MR group, 29.4±18.3mm; P<.001).

Conclusions: Our randomized clinical trial suggests that muscle relaxation facilitates i-gel insertion efficacy in anesthetized patients, as assessed by successful insertion rate, sealing pressure, and subjective difficulty of insertion.

Keywords: Muscle relaxant; Novice doctor; Randomized clinical trial; i-gel.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Airway Management / methods*
  • Androstanols*
  • Anesthesia, Intravenous
  • Anesthesiologists
  • Anesthetics, Intravenous
  • Clinical Competence
  • Female
  • Hoarseness / epidemiology
  • Humans
  • Intubation, Intratracheal / methods*
  • Male
  • Middle Aged
  • Neuromuscular Nondepolarizing Agents*
  • Pain, Postoperative / epidemiology
  • Piperidines
  • Postoperative Complications / epidemiology
  • Propofol
  • Prospective Studies
  • Remifentanil
  • Respiration, Artificial
  • Rocuronium
  • Young Adult

Substances

  • Androstanols
  • Anesthetics, Intravenous
  • Neuromuscular Nondepolarizing Agents
  • Piperidines
  • Remifentanil
  • Rocuronium
  • Propofol