Comparison of I-gel versus Endotracheal Tube in Patients Undergoing Elective Cesarean Section: A Prospective Randomized Control Study.

Background and Aim: Physiological changes during pregnancy and the sympatho adrenalstimulation during larynoscopy and intubation leads to evaluation of safe devices to secure airway during cesarean section under general anesthesia. I-gel, recently emerging effective supra glottic device found safe during general anesthesia in cesarean section. Aim of the study is to compare the hemodynamic disturbances and airway related complications of I-gel and Endotracheal tube in patients undergoing cesarean section under general anesthesia.

Material and Methods: Eighty ASA II pregnant patients posted for elective LSCS were randomly divided into two groups of 40 each ( n = 40). According to the group they were inserted either I-gel (Group I) or ETT (Group E). Insertion time, ease of intubation, hemodynamics during insertion and Extubation, airway related complications like sore throat, blood on the device, dysphagia, regurgitation, nausea, vomiting, aspiration and laryngospasm were noted and compared. Statistical analysis was done by using unpaired t test, chi square test and fisher's test. P value of <0.05 was considered as significant.

Results: The demographic parameters, ease of insertion, insertion times and adequacy of ventilation were comparable between the groups ( P > 0.05). 8 out of 40 patients in Group E had difficult intubation ( P < 0.01). More than 20% of rise in MAP and HR were found during intubation and Extubation in Group E (40 out of 40 patients) which was statistically significant when compared to Group I ( P < 0.001). Post operative sore throat significantly high in Group E (30 out of 40) ( P < 0.001) when compared to Group I (4 out of 40).

Conclusion: Easier insertion with less hemodynamic disturbances and very low incidence of sore throat I-gel found to be safer device to secure the airway in patients undergoing LSCS under general anesthesia.