title: Efficacy of the New Perilaryngeal Airway (CobraPLA™) Versus the Laryngeal Mask Airway (LMA™) to Improve Oropharyngeal Leak Pressure in Obese and Overweight Patients.
abstract: BACKGROUND
  This study aimed to evaluate the applicability of Cobra perilaryngeal airway (Cobra PLA™) for obese patients under general anesthesia and also to compare the results with those of classic laryngeal mask airway (LMA™).
  
  
  METHODS
  Seventy-three overweight and obese patients were included in this study. The patients were randomly assigned to LMA™ or Cobra PLA™ groups. Time required for intubation, successful intubation attempt, airway sealing pressure and incidence of complications including blood staining, sore throat and dysphagia were assessed and noted.
  
  
  RESULTS
  Thirty-six and 37 patients were randomly allocated to LMA™ and Cobra PLA™ groups, respectively. Most patients were males and had Mallampati Class II airway in both groups. The first attempt and overall insertion success for Cobra PLA™ was significantly higher compared to LMA (P<0.05). Airway insertion was more successful (P = 0.027; 94% vs. 77%) with Cobra PLA™. Insertion times were similar with Cobra PLA™ and LMA™ (Cobra PLA™, 29.94±16.35s; LMA™, 27.00±7.88s). The oropharyngeal leak pressure in the Cobra PLA™ group (24.80±0.90 H2O) was significantly higher than that in LMA™ group (19±1 H2O, p<0.001). Sore throat was more frequent in the LMA™ group although it did not reach statistical significance (Fisher's exact test, P = 0.33). Blood staining on airway tube was seen in both groups with a higher incidence in the Cobra PLA™ group (Fisher's Exact test, P = 0.02). Incidence of dysphagia was not different between the two groups.
  
  
  CONCLUSIONS
  CobraPLA™ was found to be safe with low complications. It provided better airway sealing with high rate of the first insertion success for use in obese and overweight patients. This study recommends the use of CobraPLA™ as a rescue device in emergency situations for obese and overweight patients.
authors.affiliation: Department of Anesthesiology, Qazvin Medical University Science, Shahid Bahonar, Qazvin, Iran.
authors.forename: Siamak
authors.initials: S
authors.lastname: Yaghoobi
authors.affiliation: Department of Anesthesiology, Qazvin Medical University Science, Shahid Bahonar, Qazvin, Iran.
authors.forename: Seyed Mohamadreza
authors.initials: SM
authors.lastname: Abootorabi
authors.affiliation: Department of Anesthesiology, Qazvin Medical University Science, Shahid Bahonar, Qazvin, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Kayalha
authors.affiliation: University of Maastricht, Maastricht, The Netherlands.
authors.forename: Tom C
authors.initials: TC
authors.lastname: Van Zundert
authors.affiliation: Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Pakpour
keywords: CobraPLA™; Flexible laryngeal mask airway; Obese patients