The new perilaryngeal airway (CobraPLA) is as efficient as the laryngeal mask airway (LMA) but provides better airway sealing pressures.
The Laryngeal Mask Airway (LMA) is a frequently used efficient airway device, yet it sometimes seals poorly, thus reducing the efficacy of positive-pressure ventilation. The Perilaryngeal Airway (CobraPLA) is a novel airway device with a larger pharyngeal cuff (when inflated). We tested the hypothesis that the CobraPLA was superior to the LMA with regard to insertion time and airway sealing pressure and comparable to the LMA in airway adequacy and recovery characteristics. After midazolam and fentanyl administration, 81 ASA physical status I-II outpatients having elective surgery were randomized to receive an LMA or CobraPLA. Anesthesia was induced with propofol (2.5 mg/kg IV), and the airway was inserted. We measured 1) insertion time; 2) adequacy of the airway (no leak at 15-cm-H2O peak pressure or tidal volume of 5 mL/kg); 3) airway sealing pressure; 4) number of repositioning attempts; and 5) sealing quality (no leak at tidal volume of 8 mL/kg). At the end of surgery, gastric insufflation, postoperative sore throat, dysphonia, and dysphagia were evaluated. Data were compared with unpaired Student's t-tests, chi2 tests, or Fisher's exact tests; P < 0.05 was significant. Patient characteristics, insertion times, airway adequacy, number of repositioning attempts, and recovery were similar in each group. Airway sealing pressure was significantly greater with CobraPLA (23 +/- 6 cm H2O) than LMA (18 +/- 5 cm H2O, P < 0.001). The CobraPLA has insertion characteristics similar to the LMA but better airway sealing capabilities.
Outcomes Research™ Institute and the Departments of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky.
Ozan
O
Akça
Anupama
A
Wadhwa
Papiya
P
Sengupta
Jaleel
J
Durrani
Keith
K
Hanni
Mary
M
Wenke
Yüksel
Y
Yücel
Rainer
R
Lenhardt
Anthony G
AG
Doufas
Daniel I
DI
Sessler
D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000295:instrumentation*; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D011292:Premedication; D011312:Pressure; D012121:Respiration, Artificial; D013990:Tidal Volume / Q000502:physiology; D014132:Trachea / Q000033:anatomy & histology / Q000502:physiology; D014832:Voice Disorders / Q000453:epidemiology / Q000209:etiology