Application of PEEP using the i-gel during volume-controlled ventilation in anesthetized, paralyzed patients

Purpose

This prospective, randomized trial was designed to assess whether the i-gel supraglottic airway device is suitable for volume-controlled ventilation while applying positive end-expiratory pressure (PEEP) of 5 cmH₂O under general anesthesia. It was believed that this device might improve arterial oxygenation.

Methods

Forty adult patients (aged 20–60 years) scheduled for elective orthopedic surgery were enrolled in this study. Twenty patients were ventilated without external PEEP [zero positive end-expiratory pressure (ZEEP) group], and the other 20 were ventilated with PEEP 5 cmH₂O (PEEP group) after placing an i-gel device. Volume-controlled ventilation at a tidal volume (TV) of 8 ml/kg of ideal body weight, leak volume, and arterial blood gas analysis were investigated.

Results

The incidences of a significant leak were similar in the ZEEP and PEEP groups (3/20 and 1/20, respectively; P = 0.605), as were leak volumes. No significant PaO₂ difference was observed between the two groups at 1 h after satisfactory i-gel insertion (215 ± 38 vs. 222 ± 54; P = 0.502).

Conclusions

The use of an i-gel during PEEP application at 5 cmH₂O did not increase the incidence of a significant air leak, and a PEEP of 5 cmH₂O failed to improve arterial oxygenation during controlled ventilation in healthy adult patients.