Comparison of the CobraPLA (Cobra Perilaryngeal Airway) and the Laryngeal Mask Airway Unique in children under pressure controlled ventilation.
BACKGROUND
The Laryngeal Mask Airway-Unique (LMAU) and CobraPLA (Cobra Perilaryngeal Airway) are supraglottic airway devices. There are no published studies comparing these devices in children breathing with pressure controlled ventilation (PCV).


METHODS
Eighty pediatric patients, scheduled for elective general surgery of short duration, were randomly assigned to have either a CobraPLA or a LMAU used for airway management using PCV. We compared the devices with respect to (i) ability to form an effective cuff seal, (ii) oxygenation, (iii) endtidal carbon dioxide level, (iv) time to achieve an effective airway, (v) airway interventions required for insertion, (vi) fiberoptic score, (vii) respiratory variables and (vii) adverse events.


RESULTS
Cuff seal pressure was significantly higher for CobraPLA (27.08 +/- 4.15 cmH(2)O) than for LMAU (20.91 +/- 2.47 cmH(2)O). Oxygenation was similar in both groups while the mean endtidal CO(2) in the CobraPLA group was significantly higher than in the LMAU group (36.47 +/- 1.93 mmHg vs 34.71 +/- 3.05 mmHg, P = 0.021). Time and ease of insertion were similar, with CobraPLA requiring more frequent jaw lift and LMAU requiring more frequent adjustment of the head and neck to achieve a proper position. Fiberoptic scores were excellent with both devices. Respiratory variables were similar with the exception that the plateau pressure and mean peak pressures were significantly lower with CobraPLA. There was a low rate of blood mucosal staining of the devices. No patient in either group reported a sore throat.


CONCLUSIONS
Both devices appear to be safe and effective in establishing an adequate airway in healthy children undergoing surgery of short duration with PCV.
Gaitini
Luis
L
Anesthesiology Department, Bnai Zion Medical Center, Haifa, Israel. luis.gaitini@b-zion.org.il
Carmi
Nurit
N
Yanovski
Boris
B
Tome
Riad
R
Resnikov
Igor
I
Gankin
Igor
I
Somri
Mostafa
M
Alfery
David
D
D002245:Carbon Dioxide / Q000032:analysis; D002675:Child, Preschool; D004209:Disposable Equipment; D017558:Elective Surgical Procedures; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D017214:Laryngeal Masks / Q000009:adverse effects; D008991:Monitoring, Physiologic / Q000379:methods; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods*; D013990:Tidal Volume; D013997:Time Factors
D002245:Carbon Dioxide