外科と麻酔のジャーナル

概要

Comparison of Actual and Ideal Body Weight for Size Selection of I-Gel^TM Laryngeal Mask Airway in Obese Patients

Syafri Kamsul Arif, Tirta Swarga, Syamsul Hilal Salam, Syafruddin Gaus and Muh Ramli Ahmad

Background: The manufacturers of i-gel™ Laryngeal Mask Airway (LMA) recommend size selection by actual body weight (ABW). However, this actual weight-related size selection may not be satisfactory in some patients because of the wide range of weights for each device size and individual anatomical variation.

Objective: The purpose of our study was to compare the application of actual and ideal body weight (IBW), either to select the appropriate size of the i-gel™ LMA in obese patients.

Methods: This study was a randomized clinical trial. Twenty-two patients with age 17 to 60 year, body mass index (BMI) 30-35 kg/m², and the difference between LMA sizes based on ABW and IBW were allocated to ABW and IBW group. After insertion of the device, several variables including insertion parameters, sealing function, gastric channel function, and post-operative complications were recorded. The statistics data were analyzed with SPSS version 24 software, which p value<0.05 is considered significant.

Results: The first attempt insertion success rate was lower in the ABW group than IBW group showing a significant difference. The IBW group show a significant higher first attempt insertion rate (p=0.025), shorter insertion time (p=0.02) and easier placement (p=0.017). Gastric channel function and postoperative complications were similar in both groups.

Conclusions: Using IBW shows better performance for size selection of the i-gel™ LMA in obese patients than ABW.