Efficacy and Safety of the I-Gel Versus Cuffed Tracheal Tube in Prolonged Pressure-Controlled Ventilation

Abstract

Background: In prolonged pressure-controlled ventilation, the choice between the i-gel supraglottic airway device and cuffed tracheal tube remains debated regarding efficacy and safety. This study aims to compare the efficacy and safety of the i-gel versus cuffed tracheal tube in prolonged pressure-controlled ventilation.
Materials and Methods: A prospective randomized controlled trial was conducted among 200 adult patients requiring prolonged pressure-controlled ventilation. Patients were randomly allocated into two groups: the i-gel group (n=100) and the cuffed tracheal tube group (n=100). Efficacy was assessed through airway sealing pressure, ventilatory parameters, and incidence of airway-related complications. Safety was evaluated based on the incidence of complications such as aspiration, laryngopharyngeal injury, and post-extubation airway obstruction.
Results: The mean airway sealing pressure was significantly higher in the i-gel group compared to the cuffed tracheal tube group (p < 0.001). Ventilatory parameters, including tidal volume and peak airway pressure, did not significantly differ between the two groups (p > 0.05). The incidence of airway-related complications was lower in the i-gel group (12%) compared to the cuffed tracheal tube group (20%). Safety outcomes showed a lower incidence of aspiration, laryngopharyngeal injury, and post-extubation airway obstruction in the i-gel group compared to the cuffed tracheal tube group.
Conclusion: In prolonged pressure-controlled ventilation, the i-gel supraglottic airway device demonstrates superior efficacy in terms of airway sealing pressure and lower incidence of airway-related complications compared to the cuffed tracheal tube. Additionally, the i-gel exhibits comparable safety profiles, suggesting its potential as a viable alternative in such settings.