Comparison of Cobra perilaryngeal airway (CobraPLA TM ) with flexible laryngeal mask airway in terms of device stability and ventilation characteristics in pediatric ophthalmic surgery

• Main Authors: Rani A Sunder (Author), Renu Sinha (Author), Anil Agarwal (Author), Bala Chandran Sundara Perumal (Author), Sakthi Rajan Paneerselvam (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2012-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0970-9185; 10.4103/0970-9185.98324
• Keywords: Airway complication; CobraPLA TM; flexible laryngeal mask airway; pediatric ophthalmic surgery; Anesthesiology; RD78.3-87.3; Pharmacy and materia medica; RS1-441
• Source: Journal of Anaesthesiology Clinical Pharmacology, Vol 28, Iss 3, Pp 322-325 (2012)

Background: Supraglottic airway devices play an important role in ophthalmic surgery. The flexible laryngeal mask airway (LMA TM ) is generally the preferred airway device. However, there are no studies comparing it with the Cobra perilaryngeal airway (CobraPLA TM ) in pediatric ophthalmic procedures. Aims: To analyze the intraoperative device stability and ability to maintain normocarbia of CobraPLA TM and compare it to that with flexible LMA TM . Materials and Methods: Ninety children of American Society for Anesthesiologists physical status 1 and 2, aged 3-15 years scheduled for elective ophthalmic surgeries were randomly assigned to either the CobraPLA TM or the flexible LMA TM group. After placement of each airway device, oropharyngeal leak pressure (OLP) was noted. Adequate seal of the devices was confirmed at an inspired pressure of 15 cm H 2 O and pressure-controlled ventilation was initiated. Device displacement was diagnosed if there was a change in capnograph waveform, audible or palpable gas leak, change in expired tidal volume to <8 ml/kg, end-tidal carbon-dioxide persistently >6 kPa, or need to increase inspired pressure to >18 cm H 2 O to maintain normocarbia. Results: Demographic data, duration, and type of surgery in both the groups were similar. A higher incidence of intraoperative device displacement was noted with the CobraPLA TM in comparison to flexible LMA TM (P < 0.001). Incidence of displacement was higher in strabismus surgery (7/12). Insertion characteristics and ventilation parameters were comparable. The OLP was significantly higher in CobraPLA TM group (28 ± 6.8 cm H 2 O) compared to the flexible LMA TM group (19.9 ± 4.5 cm H 2 O) (P < 0.001). Higher surgeon dissatisfaction (65.9%) was seen in the CobraPLA TM group. Conclusion: The high incidence of device displacement and surgeon dissatisfaction make CobraPLA TM a less favorable option than flexible LMA TM in ophthalmic surgery.