title: Laryngeal view and temperature measurements while using the perilaryngeal airway (Cobra-PLUS™) in children.
abstract: BACKGROUND
  The Cobra-PLUS™ perilaryngeal airway (CP) is a modification of the Cobra perilaryngeal airway. It has a distal curve for easier placement and a thermistor on the pharyngeal cuff. We assessed the orientation of the larynx to the CP and compared temperatures measured using CP to temporal arterial (TA) and infrared tympanic (T) thermometers.
  
  
  METHODS
  American Society of Anesthesiologists (ASA) physical status 1 and 2 children 0-18 years old undergoing general anesthesia using CP were grouped into different weight cohorts. A fiberoptic scope was inserted through the CP, and laryngeal views were recorded and graded off line. Temperatures were measured from the CP, TA, and T at 15-min intervals for four readings or until the end of surgery. The CP was removed, while the patient was deeply anesthetized.
  
  
  RESULTS
  Eighty subjects were analyzed. 87.5% (cohort range 75-95%) had an unobstructed view of the larynx. No serious adverse effects noted. Three hundred and sixteen temperature data points were recorded for each measured site. CP temperatures were consistently lower than TA and T with a bias of 0.9 and 0.6°C, respectively. Using temperatures measured at time 0 and 15 min, CP was associated with a larger intraclass correlation coefficient and smaller repeatability coefficient when compared to TA or T (ICC 0.65, 0.46. 0.44 and RC 0.78, 1, 1.36, respectively), indicating it had a better measure and remeasure reliability.
  
  
  CONCLUSIONS
  The CP has a better orientation to the larynx compared with its previous version. It may be used to reliably trend intraoperative temperatures.
authors.affiliation: Department of Anesthesiology, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Gee Mei
authors.initials: GM
authors.lastname: Tan
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Galinkin
authors.forename: Zhaoxing
authors.initials: Z
authors.lastname: Pan
authors.forename: David M
authors.initials: DM
authors.lastname: Polaner
mesh_terms: D000293:Adolescent; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods*; D000768:Anesthesia, General; D001193:Arytenoid Cartilage / Q000033:anatomy & histology; D001831:Body Temperature / Q000502:physiology*; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007223:Infant; D007830:Larynx / Q000033:anatomy & histology*; D008297:Male; D062125:Thermometry
keywords: airway management; body temperature; children; infants; intraoperative monitoring; supraglottic airway devices