Back ground : Paediatric patients posted for VP shunt procedure pose unique challenge in securing airway due to various reasons (craniofacial abnormalities, CHD & respiratory problems). Paediatric I-gel’s ( 1& 1.5 ) were evaluated for airway management in these patients.

Methods: A prospective observational study conducted at Osmania General Hospital in 70 patients selected at random in age group -neonates to 15 months(<10kg body wt. ) posted for VP Shunt procedures under GA . I-gel Size 1 was used for 2-5 kg wt. & 1.5 used for 5 –10 kg wt. patients. Outcome measured as performance of i-gel , insertion time, first insertion success rate , no. of insertion attempts , ease of insertion , manipulation rates during use , effective ventilation , hemodynamic parameters (HR & NIBP ), reported complications associated with the device and anaesthesia related mortality in these patients.

Results: We studied 70 patients with size # 1 I-gel used in 32 patients , size # 1.5 in 38 patients Results were analysed using Microsoft Excel spread sheet There were no failures in insertion of i-gel the success rate for inserting the device was 85% in the first attempt and 100% after two/three attempts.The quality of airway was clear throughout in 90% of patients . The usefulness and performance of device was excellent / good in majority of the patients( 90 % ) with good hemodynamic stability. Anaesthesia related morbidity and mortality in the immediate post-operative period was reduced and follow up of these patients for 2 week showed better survival .

Discussion: I-gel is a new single-use, non-inflatable supraglottic airway device , anatomically designed mask made of a gel-like thermoplastic elastomer effectively sealing perilaryngeal structures .Few studies are reported on i-gel sizes 1 & 1.5 in this age group. With respect to our study , the i-gel was inserted without complications, establishing a clear airway and enabling spontaneous and assisted /controlled ventilation. The i-gel provided a satisfactory airway management device in VP Shunt procedures with minimal complications. Conclusions: Our study showed the i-gel is a satisfactory alternative to endotracheal intubation has simplified airway management in VP Shunt procedures and decreased anaesthesia related morbidity and morbidity in immediate post-operative period resulting in better survival of patients.