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AMBULATORY ANESTHESIA

A Randomized Prospective Study Comparing the Cobra Perilaryngeal Airway and Laryngeal Mask Airway-Classic During Controlled Ventilation for Gynecological Laparoscopy

From the Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands.

Address correspondence and reprint requests to Eilish Galvin, MB, FCARCSI, Department of Anesthesiology, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3015 GD Rotterdam, The Netherlands. Address e-mail to eilishgalvin{at}hotmail.com.

BACKGROUND: An increasing number of noninvasive, supraglottic airway devices are currently available. In this randomized single-blind study, we compared the Cobra Perilaryngeal Airway (CobraPLA) to the [Laryngeal Mask Airway (LMA)-Classic] during gynecological laparoscopy.

METHODS: Forty patients received either an LMA-Classic or a CobraPLA. Insertion, ventilation and removal characteristics were noted, as well as any throat morbidity.

RESULTS: Devices were similar for insertion characteristics, adverse events, and throat morbidity. Before pneumoperitoneum, peak airway pressures were 20.3 ± 4.9 cm H₂O in the LMA-Classic group versus 25.5 ± 7.9 cm H₂O in the CobraPLA group, P = 0.01. This difference was maintained during pneumoperitoneum; LMA-Classic (22.8 ± 6.1 cm H₂O) and CobraPLA (28.1 ± 8.5 cm H₂O), P = 0.04. Macroscopic blood occurred only on the CobraPLA, seen on 40% of the devices after removal, P = 0.001.

CONCLUSION: During gynecological laparoscopy, the CobraPLA provides similar insertion characteristics, but higher airway sealing pressures than the LMA-Classic. The usefulness of this finding requires further investigation.

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