Abstract

Objective: Supraglottic airway devices are pivotal tools for airway management in anesthesia. The I-gel, a widely used second-generation airway device, is recognized for ease of insertion and low complication rate. This study aims to compare the ease of insertion of I-gel and associated insertion conditions when used with Fentanyl and Dexmedetomidine in combination with Propofol.

Methods: After obtaining approval of ethical committee, a total of 60 patients were enrolled a tertiary care hospital and divided into two groups. Group F received 2 mcg/kg of intravenous fentanyl and propofol; Group D received 1 mcg/kg of intravenous dexmedetomidine infusion in 10 minutes and propofol. The ease of I-gel insertion and jaw relaxation was assessed using the modified Lund and Stovener criteria and Young’s criteria, respectively. The physiologic variables, adverse events like apnea, desaturation, cough, jaw movement; and additional requirement of propofol bolus doses were recorded at baseline, first, third, fifth and tenth minutes after insertion.

Results: No significant differences were observed in jaw relaxation, ease of I-gel insertion, and adverse events. The apnea duration was shorter in Group D (12.1±2.3 min vs 15.1±2.8, p<0.001). Respiratory rate was significantly lower in Group F. It was easier to insert I-gel in Group D (p=0.213). Ramsay Score was higher and Aldrete score was lower in Group D (p<0.001).

Conclusion: Dexmedetomidine as an adjuvant to propofol is a safe alternative to combination of propofol and fentanyl in pediatric surgeries. Although both drugs maintain a stable hemodynamic profile, dexmedetomidine demonstrates superior efficacy in preserving respiratory stimulus.

Keywords: I-gel, supraglottic airway device, hemodynamic, upper airway reflexes, dexmedetomidine, fentanyl

Copyright and license

Copyright © 2026 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
NA, Hymavathi J, Yamajala H, Putcha S. Comparison of I-gel insertion using propofol-fentanyl vs propofol-dexmedetomidine in pediatric day surgery. Northwestern Med J. 2026;6(1):281-8. https://doi.org/10.54307/2026.NWMJ.126

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