Evaluation of first pass success rate of intubation through i-gel Plus in anesthetized patients without anticipated difficult airway

Effective airway management is a cornerstone of anaesthesia, with successful intubation on the first attempt being associated with reduced complications such as hypoxia, trauma and haemodynamic stability. Recently, supraglottic airway devices (SGADs) with a conduit for tracheal intubation are gaining popularity as a bridge between ventilation and intubation in all patient populations. Furthermore, endotracheal intubation using SGAD is a widely investigated and accepted technique that has been recognised on the emergency pathway of the American Society of Anaesthesiologists’ Difficult Airway Algorithm.The i-gel Plus (Intersurgical Ltd) is an improved version of i-gel with additional features incorporated in the device, such as a supplementary oxygen port for the administration of passive oxygenation as a component of cardiocerebral resuscitation (CCR), a larger gastric channel, an intubation ramp and a longer non-inflatable cuff tip for improving oropharyngeal leak pressure.The intubation ramp provided in the bowl of the non-inflatable cuff helps to ensure an optimal angle of the tracheal tube as it exits the device, allowing reliable and safe passage through the vocal cords into the trachea. Direct laryngoscopy and intubation can induce sympathetic stimulation and potential haemodynamic responses like hypertension and tachycardia. This negative physiological response can be mitigated by intubation through a supraglottic device such as the i-gel plus. However, the clinical performance of i-gel plus is underexplored. Recently, a cadaveric study demonstrated that i-gel plus acts as a superior conduit for fibreoptic intubation than standard i-gel. Its performance as an intubation conduit has not been studied in patients. Hence, we plan to evaluate the safety, feasibility and first pass success rate of endotracheal intubation through i-gel plus