Atelectasis (collapse of part of the lung) is a common complication during and after general anaesthesia in children. It can reduce oxygenation, cause breathing problems, and increase the risk of postoperative complications. Different airway devices used during anaesthesia may influence the risk of atelectasis.

The i-gel is a supraglottic airway device that is easy to insert, causes less irritation, and maintains airway patency during anaesthesia. The endotracheal tube (ETT) is the conventional method for airway management but requires more manipulation, may cause airway irritation, and can be associated with a higher risk of atelectasis.

This study is a randomized clinical trial comparing i-gel and ETT in children aged 1–14 years undergoing elective surgeries lasting more than one hour. One hundred children will be enrolled and randomly assigned to either i-gel or ETT groups. Lung ultrasound, a safe and radiation-free bedside tool, will be used to assess atelectasis at different time points during and after surgery.

The primary outcome is the degree of atelectasis 15 minutes after airway insertion. Secondary outcomes include atelectasis at extubation and 30 minutes after extubation, airway complications (such as sore throat and hoarseness), postoperative pulmonary complications, and hospital stay.

The results of this study will help determine whether i-gel or ETT is better in reducing lung atelectasis and improving recovery in children undergoing anaesthesia.