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Efficacy of I- gel™ for airway management of neonates with Pierre Robin sequence undergoing glossopexy: A prospective

Vikram Shetty1, Sripada G Mehendale2, Muralishankar Bhat2

  • 1Nitte Meenakshi Institute of Craniofacial Surgery, Nitte Deemed to be University, India.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|July 5, 2022
PubMed

Insights

The I-gel device offers a reliable airway management solution for infants with Pierre Robin sequence (PRS) undergoing glossopexy. This study found it effective in managing difficult airways during the procedure with no complications.

Area of Science:

  • Pediatric Anesthesiology
  • Airway Management
  • Neonatal Surgery

Background:

  • Pierre Robin sequence (PRS) presents significant airway challenges in neonates.
  • Glossopexy is a surgical procedure to correct tongue-based airway obstruction in PRS.
  • Effective airway management is critical for successful glossopexy outcomes.

Purpose of the Study:

  • To evaluate the efficacy of the I-gel supraglottic airway device.
  • To assess I-gel as a device for managing difficult airways in infants with PRS during glossopexy.
  • To compare I-gel with traditional airway management techniques in this specific population.

Main Methods:

  • A prospective study involving neonates diagnosed with Pierre Robin sequence.
  • Implementation of a structured airway management protocol including tongue traction stitch.
  • Sequential attempts with direct laryngoscopy and fiberoptic intubation, followed by I-gel insertion if needed.
  • Data collection on successful intubation and airway management during glossopexy.

Main Results:

  • A total of 31 PRS neonates were included in the study.
  • Successful airway management was achieved in all patients using the described protocol.
  • 13 patients were successfully intubated using the I-gel device.
  • No postoperative complications were reported in any of the patients.

Conclusions:

  • The I-gel device appears to be a relevant and effective alternative for airway management in infants with PRS undergoing glossopexy.
  • It provides reliable and secure airway access, potentially simplifying the procedure.
  • Further studies are warranted to confirm these findings within the limitations of this study.

Keywords:
Cleft palateDifficult airwayGlossoptosisI-gel™MicrognathiaPierre robin sequence

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