Comparison between i-gel and endotracheal tube in corneal grafts: a randomized clinical trial

Purpose To assess the safety of the laryngeal mask I-Gel® in keratoplasty (KP) performed under general anaesthesia. Methods Patients with indications for KP (n = 110) were enrolled in a prospective study and randomly assigned to I-Gel® (n = 55; 30 lamellar KP and 25 penetrating KP) or tracheal tube (n = 55; 29 lamellar KP and 26 penetrating KP). Peri-operative complications and recovery time were compared between two groups using t-test or χ2 test. Contraindications to elective use of the laryngeal mask airway were exclusion criteria (oesophageal reflux, extreme obesity, oropharyngeal pathology, expected difficult intubation). Results No surgical peri-operative complications were reported in either group. There was a significantly greater incidence of coughing at extubation and after extubation in the tracheal group (25/55; 45%) than in the laryngeal mask group (3/55; 5%) (p < 0.001). Recovery time was shorter in the I-Gel® group (80 min; 95%CI [75–86]) compared with the tracheal tube group (88 min; 95%CI [82–95]) (p = 0.03). There were no significant differences in the incidence of sore throat and hoarseness between the two devices. Conclusions The use of I-Gel® for keratoplasty under general anaesthesia is safe, reduces the risk of potential ocular hypertension during recovery and saves recovery time.