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GENERAL ARTICLES

The New Perilaryngeal Airway (CobraPLA^TM) Is as Efficient as the Laryngeal Mask Airway (LMA^TM) but Provides Better Airway Sealing Pressures

OUTCOMES RESEARCH^TM Institute and the Departments of Anesthesiology and Pharmacology, University of Louisville, Louisville, Kentucky

Address correspondence and reprint requests to Ozan Akça, MD, OUTCOMES RESEARCH Institute, 501 E. Broadway, Suite 210, Louisville, KY 40202. Address email to ozan.akca{at}louisville.edu

The Laryngeal Mask Airway (LMA) is a frequently used efficient airway device, yet it sometimes seals poorly, thus reducing the efficacy of positive-pressure ventilation. The Perilaryngeal Airway (CobraPLA) is a novel airway device with a larger pharyngeal cuff (when inflated). We tested the hypothesis that the CobraPLA was superior to the LMA with regard to insertion time and airway sealing pressure and comparable to the LMA in airway adequacy and recovery characteristics. After midazolam and fentanyl administration, 81 ASA physical status I–II outpatients having elective surgery were randomized to receive an LMA or CobraPLA. Anesthesia was induced with propofol (2.5 mg/kg IV), and the airway was inserted. We measured 1) insertion time; 2) adequacy of the airway (no leak at 15-cm-H₂O peak pressure or tidal volume of 5 mL/kg); 3) airway sealing pressure; 4) number of repositioning attempts; and 5) sealing quality (no leak at tidal volume of 8 mL/kg). At the end of surgery, gastric insufflation, postoperative sore throat, dysphonia, and dysphagia were evaluated. Data were compared with unpaired Student’s t-tests, ² tests, or Fisher’s exact tests; P < 0.05 was significant. Patient characteristics, insertion times, airway adequacy, number of repositioning attempts, and recovery were similar in each group. Airway sealing pressure was significantly greater with CobraPLA (23 ± 6 cm H₂O) than LMA (18 ± 5 cm H₂O, P < 0.001). The CobraPLA has insertion characteristics similar to the LMA but better airway sealing capabilities.

IMPLICATIONS: The perilaryngeal airway (CobraPLA) has insertion characteristics similar to those of the laryngeal mask airway but better airway sealing capabilities. This better sealing might improve the ability to provide mechanical ventilation.

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