{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:22:35Z","timestamp":1788153755486,"version":"build-2803163510"},"reference-count":16,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Gastric insufflation may occur during positive-pressure ventilation through a supraglottic airway when airway pressure exceeds the seal pressure. Because pressure-controlled ventilation (PCV) lowers peak inspiratory pressure compared with volume-controlled ventilation (VCV), it is widely assumed to reduce gastric insufflation\u2014an assumption that remains untested in adults. We therefore compared these two ventilation modes during i-gel ventilation. Materials and Methods: In this single-centre, assessor-blinded randomised controlled trial, 68 adults undergoing elective breast surgery under general anaesthesia with an i-gel and neuromuscular blockade, without a gastric drain tube, were allocated 1:1 to PCV or VCV (tidal volume 8 mL\/kg of actual body weight). The primary outcome was the postoperative gastric antral cross-sectional area measured by ultrasonography, an indirect measure of gastric gas. The pre-specified primary analysis was a Student\u2019s t-test. Secondary outcomes included peak inspiratory pressure and oropharyngeal leak pressure; gastric insufflation, defined post hoc as a &gt;30% increase in antral area, was assessed as an exploratory outcome. Results: All 68 participants (34 per group) were analysed. The postoperative antral cross-sectional area did not differ between groups (mean difference, PCV \u2212 VCV, \u221223.7 mm2; 95% CI \u221273.9 to 26.4; p = 0.347; p = 0.568 after adjustment for baseline); the confidence interval excluded the 100 mm2 difference the trial was powered to detect. Gastric insufflation occurred in 2\/34 (VCV) versus 3\/34 (PCV) (p = 1.000). Peak inspiratory pressure and expiratory tidal volume were lower with PCV (all p \u2264 0.002), whereas oropharyngeal leak pressure was similar; in every patient, peak pressure remained below the leak pressure. No adverse events occurred. Conclusions: In adults ventilated through an i-gel at the low airway pressures this device produces, PCV lowered peak inspiratory pressure but did not reduce the postoperative antral cross-sectional area or the incidence of gastric insufflation compared with VCV. Because delivered tidal volume was also lower with PCV, the peak pressure difference is reported descriptively. Within this low-pressure range, and in this selected population, the ventilation mode did not detectably affect gastric insufflation; the trial does not establish equivalence between the modes or extend to higher airway pressures or obesity.<\/jats:p>","DOI":"10.3390\/medicina62091657","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T02:08:58Z","timestamp":1788142138000},"page":"1657","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Pressure-Controlled Versus Volume-Controlled Ventilation on Gastric Insufflation During i-gel Use in Adults: A Randomised Controlled Trial"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6650-0396","authenticated-orcid":false,"given":"Jiwon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5516-0333","authenticated-orcid":false,"given":"Hyoung Woo","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam-si 13620, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8760-4568","authenticated-orcid":false,"given":"Min-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Severance Hospital, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0486-6148","authenticated-orcid":false,"given":"Hae Dong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si 10444, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joung Goo","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si 10444, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1963-8955","authenticated-orcid":false,"given":"Hyun Joo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1093\/bja\/aes309","article-title":"i-gel\u2122 Supraglottic Airway in Clinical Practice: A Prospective Observational Multicentre Study","volume":"109","author":"Theiler","year":"2012","journal-title":"Br. 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