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Anesth Analg 2006;102:1685-1688
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000219594.94252.F5

PEDIATRIC ANESTHESIA

Video Assessment of Supraglottic Airway Orientation Through the Perilaryngeal Airway in Pediatric Patients

David M. Polaner, MD, FAAP, Dheeraj Ahuja, MD, Jeannie Zuk, PhD, RN, and Zhaoxing Pan, PhD

The Children's Hospital and University of Colorado School of Medicine, Department of Anesthesia, Denver, Colorado

Address correspondence and reprint requests to David M. Polaner, MD, FAAP, The Children's Hospital Department of Anesthesia, 1056 East 19th Avenue, B090, Denver, CO 80218. Address e-mail to polaner.david{at}tchden.org.

The COBRA perilaryngeal airway (PLA) is a new supraglottic airway device available for use in children. We studied the orientation of the larynx as viewed through the PLA using video obtained with a fiberoptic bronchoscope in 45 infants and children. Laryngeal view was scored, and position of the grill bars of the PLA and the epiglottis was assessed. An acceptable airway was obtained in all subjects, but the laryngeal view was nearly or completely obstructed in 76.9% of the patients 10 kg and less, with the epiglottis folded over the glottic opening. This was uncommon in larger children. The grill bars of the PLA were closely opposed to the epiglottis and supraglottic structures in nearly all subjects. We conclude that 1) the PLA provides an acceptable airway in infants and children, but infolding of the epiglottis with obstruction of the view of the glottic opening is common in infants, 2) extra vigilance for airway obstruction in this age group is necessary, and 3) the PLA's close opposition to the supraglottic structures suggests that removal in a deeper plane of anesthesia might minimize laryngeal stimulation.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.