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Comparison of the CobraPLA TM (Cobra Perilaryngeal Airway) and the Laryngeal Mask Airway Unique TM in children under pressure controlled ventilation
Author(s) -
GAITINI LUIS,
CARMI NURIT,
YANOVSKI BORIS,
TOME RIAD,
RESNIKOV IGOR,
GANKIN IGOR,
SOMRI MOSTAFA,
ALFERY DAVID
Publication year - 2008
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2008.02449.x
Subject(s) - medicine , laryngeal mask airway , airway , anesthesia , sore throat , cuff , airway management , peak inspiratory pressure , ventilation (architecture) , respiratory rate , laryngoscopy , respiratory system , surgery , intubation , blood pressure , heart rate , tidal volume , mechanical engineering , engineering
Summary Background: The Laryngeal Mask Airway‐Unique (LMAU) and CobraPLA TM (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 TM 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 TM (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 TM 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 TM 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 TM . 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.