Comparison of no airway device, the Guedel-type airway and the Cuffed Oropharyngeal Airway with mask ventilation during manual in-line stabilization.
OBJECTIVE
To compare two different types of oropharyngeal airway: the Guedel-type oral airway and the Cuffed Oropharyngeal Airway (COPA), with respect to the effectiveness of positive-pressure ventilation (PPV) through a face mask in patients with in-line stabilization of the head and neck.


METHODS
Prospective, randomized, crossover study.


METHODS
University hospital.


METHODS
30 ASA physical status I and II patients undergoing elective surgery.


METHODS
General anesthesia was induced with propofol and muscle relaxation was produced with vecuronium. In a random sequence, no airway device, the Guedel-type airway, and the COPA were used in each patient while applying a face mask and lifting the jaw forward.


RESULTS
Tidal volumes were measured during PPV in each option. The position of the distal tip of each airway was assessed using a fiberscope, and the resulting views were graded and compared. When the Guedel-type airway was used, tidal volumes (V(T)s; means +/- SD) were significantly greater (12.3 +/- 4.5 mL/kg) than those with no airway device (8.5 +/- 4.5 mL/kg) (p < 0.001). When the COPA was used, V(T)s (14.6 +/- 4.4 mL/kg) were significantly greater than those with the Guedel-type airway (p < 0.05). The grade of the fiberscopic view through the distal tip was significantly better with the COPA than with the Guedel-type airway (p < 0.05).


CONCLUSIONS
Although clinical differences often appear trivial, the COPA is more effective on mask ventilation than the Guedel-type airway when used in patients with manual in-line stabilization.
Department of Anesthesiology, University of Occupational and Environmental Health, School of Medicine, Yahatanishi, 807-8555, Kitakyushu, Japan. kkoga@med.uoeh-u.ac.jp
K
K
Koga
T
T
Sata
M
M
Kaku
K
K
Takamoto
A
A
Shigematsu
D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D001999:Bronchoscopy; D018592:Cross-Over Studies; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D011229:Preanesthetic Medication; D013119:Spinal Cord Injuries / Q000503:physiopathology