[Successful use of i-gel in three patients with difficult intubation and difficult ventilation]

I report successful ventilation through the i-gel and tracheal intubation through it, in patients in whom both facemask ventilation and tracheal intubation were difficult. Case 1: A 54-year-old woman, 157 cm, 60 kg, was scheduled for laparoscopic cholecystectomy. Preoperatively, neither difficult intubation nor difficult mask ventilation was predicted. After induction of anesthesia and neuromuscular blockade, both tracheal intubation and facemask ventilation were difficult. Insertion of a size 3 i-gel allowed adequate ventilation. The i-gel was removed and tracheal intubation was achieved using the Airway Scope. Case 2: In a 32-year-old woman, 162 cm, 46 kg, with predicted difficult intubation (thyromental distance of 4 cm), both tracheal intubation and facemask ventilation were difficult after induction of anesthesia. Insertion of a size 3 i-gel allowed adequate ventilation. Tracheal intubation through the i-gel was successful with the aid of a fibreoptic bronchoscope. Case 3: In a 54-year-old woman, 157 cm, 60 kg, with predicted difficult intubation (thyromental distance of 5 cm), both tracheal intubation and facemask ventilation were difficult after induction of anesthesia. Insertion of a size 3 i-gel allowed adequate ventilation. Fiberoptic tracheal intubation through the i-gel was successful. I feel that the i-gel has a potential role as a rescue device, by allowing ventilation and tracheal intubation in patients with difficult airways.