*7.3.5.3 Size selection, practical aspect*

The AuraGain™ comes in eight different sizes for use in patients of different weight (**Table 5**). This device is meant to be used only once. Studies suggest that AuraGain™ provides adequate sealing of the airway [78–80].

**Figure 12.** *Ambu AuraGain.*

*Special Considerations in Human Airway Management*

non-inflatable, anatomical seal of the pharyngeal, laryngeal and perilaryngeal

A horizontal line (Adult sizes 3,4 and 5 only) at the middle of the integral biteblock represents the correct position of the teeth. The soft design of the i-gel is able to retain its shape to facilitate ease of insertion. In a known difficult or unexpectedly difficult intubation, for intubating the patient, by passing an ETT through the

Size selection is done on a weight basis (**Table 6**). However, individual anatomical variations should always be considered. Patients with cylindrical necks or wide thyroid/cricoid cartilages may require a larger size i-gel than would normally be

The i-gel can be used in difficult or unanticipated difficult intubations. Owing to its ease of insertion, it can quickly establish and maintain a clear airway in a pre-hospital setting [83, 84]. In a study it was observed that hemodynamic parameters, ease of insertion and postoperative complications were comparable among the i-gel, pLMA and cLMA but airway sealing pressure was significantly

A modification of this device is the i-gel O2. It contains a supplementary oxygen

The Combitube® (Covidien-Nellcor®, Pleaseton, USA) is a single use, double-

lumen tube that combines the features of a conventional ETT with those of an

port for passive oxygen administration. It may be utilised for cardiopulmonary resuscitation. The i-gel O2 Resus Pack is a resuscitation pack provided by the manufacturer. It contains the i-gel O2 LMA, an airway support strap to fix and secure the device in place, a suction tube (12 Fr) and a pack of lubricant. The Resus Pack is available in three adult sizes (3, 4 and 5). The presence of a colour coded hook ring on the LMA allows easy identification of the size during resuscitation.

structures whilst avoiding compression trauma.

*Second Generation Supraglottic Airway (SGA) Devices DOI: http://dx.doi.org/10.5772/intechopen.93947*

The igel has the following parts (**Figure 14**):

*7.3.6.2 Device description*

• Gastric channel

• Epiglottic rest

• Airway tube

• Gastric tube

higher with i-gel [85].

*7.3.7 Combitube®*

*7.3.7.1 Introduction*

**267**

oesophageal obturator airway.

• Soft non-inflatable cuff

• Buccal cavity stabiliser

device under fibre optic guidance.

*7.3.6.3 Size selection, practical aspect, adjuncts*

recommended on a weight basis [81, 82].

#### **Figure 13.** *FOB guided intubation.*


#### **Table 5.** *Available Auragain LMAs.*

#### *7.3.6 i-gel®*

## *7.3.6.1 Introduction*

The i-gel® (Intersurgical®, UK) is the innovative second generation supraglottic airway device from Intersurgical launched in 2007. Made from a medical grade thermoplastic elastomer, i-gel has been designed to create a

non-inflatable, anatomical seal of the pharyngeal, laryngeal and perilaryngeal structures whilst avoiding compression trauma.
