Comparison of the CobraPLA and the LMA Classic airway devices during volume-controlled ventilation in children

Abstract

Background: The Cobra Perilaryngeal Airway (CobraPLA) and the Laryngeal Mas k Airway (LMA) Classic are supraglottic airway devices. We compared the performance of the CobraPLA and the LMA Classic devices during volume-controlled ventilation in children. Methods: Eighty children, ASA physical status I-II, aged 1−10 years were randomly assigned with either the CobraPLA or the LMA Classic for airway management. Anesthesia was induced with 1 mg/kg ketamine and 2.0 mg/kg propofol, and muscle relaxation was obtained with the use of 0.5 mg/kg rocuronium. All patients were mechanically ventilated with a tidal volume of 10 m/kg in 1−3% sevoflurane, oxygen and air. The number of insertions, oropharyngeal leak pressure, and fiberoptic airway position were measured. Measurements of blood pressure, heart rate, oxygen saturation, end-tidal carbon dioxide, and peak inspiratory pressure were recorded every 5 minutes. Postoperative adverse events were assessed. Results: There was no significant difference between the use of the two devices with respect to the number of insertions, time of insertion, and fiberoptic score. The oropharyngeal leak pressure was significantly higher for the CobraPLA than the LMA Classic (25.4 ± 4.9 cmH2O versus 20.3 ± 5.4 cmH2O; P ＜ 0.001). Hemodynamic and respiratory variables were similar with the use of both devices. The incidence of adverse events was not different with the use of both devices. Conclusions: Both airway devices provided an adequate airway and effective ventilation during volume-controlled ventilation in children. The CobraPLA had a higher sealing pressure than the LMA Classic. (Korean J Anesthesiol 2008; 55: 145～9)