A randomised comparison between Cobra PLA and classic laryngeal mask airway and laryngeal tube during mechanical ventilation for general anaesthesia. 2013

Paweł Ratajczyk, and Beata Małachowska, and Ewelina Gaszyńska, and Tomasz Gaszyński
Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, Poland.

BACKGROUND The aim of this study was to compare ventilation parameters during mechanical ventilation using Laryngeal Mask Airway (LMA), Laryngeal Tube (LT), and Peri-Laryngeal Airway Cobra (PLA). METHODS In a prospective, randomised controlled trial, 90 patients undergoing general anaesthesia for elective surgery were divided into three subgroups. The settings of controlled ventilation were: oxygen 50%, air 50%, sevoflurane 1.5-2.0%, TV 7 mL kg(-1), RR 10 breath min(-1), inspiratory/expiratory ratio 1:2 and FGF 3 L min(-1). The number of attempts, time taken to insert the device, airway pressure (peak airway pressure, plateau airway pressure), air leak (inspiratory and expiratory volume difference), and dynamic compliance were measured. The timepoints for collecting data were after successful insertion of the device, and after ten, 20, 30 and 50 mins of ventilation. The presence of visible blood traces, patients' assessment of their throat soreness, dysphonia and dysphagia were noted postoperatively. RESULTS The success rates at first insertion were 90% and 80% and 90%, while time for insertion was 5 sec and 21.94 sec and 5.24 sec in the Cobra PLA, LMA and LT groups respectively. Ventilation pressures during procedure were highest in the LT group, where compliance was lowest compared to the Cobra PLA and LMA groups. The air leak was similar in all the groups. 30% vs. 40% vs. 10% of devices had positive blood traces; 20% vs. 40% vs. 30% of patients suffered from a sore throat; and 30% vs. 30% and 30% of patients suffered from dysphagia in the Cobra PLA, LMA and LT groups respectively. CONCLUSIONS The differences were small, but Cobra PLA seemed to be slightly superior in terms of the measured parameters.

UI MeSH Term Description Entries
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010612 Pharyngitis Inflammation of the throat (PHARYNX). Sore Throat,Pharyngitides,Sore Throats,Throat, Sore
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias

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