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Evaluation of the Cobra perilaryngeal airway (CPLA) as an airway conduit*

Published online by Cambridge University Press:  01 October 2007

J. J. Lee ,
J. A. Kim ,
M. S. Gwak  and
M. H. Kim
J. J. Lee
Affiliation:
Sungkyunkwan University, School of Medicine, Samsung Medical Center, Department of Anesthesiology and Pain Medicine, Seoul, Korea
J. A. Kim*
Affiliation:
Sungkyunkwan University, School of Medicine, Samsung Medical Center, Department of Anesthesiology and Pain Medicine, Seoul, Korea
M. S. Gwak
Affiliation:
Sungkyunkwan University, School of Medicine, Samsung Medical Center, Department of Anesthesiology and Pain Medicine, Seoul, Korea
M. H. Kim
Affiliation:
Sungkyunkwan University, School of Medicine, Samsung Medical Center, Department of Anesthesiology and Pain Medicine, Seoul, Korea
*
Correspondence to: Jie Ae Kim, Department of Anesthesiology and Pain Medicine, Samsung Medical Center, 50, Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. E-mail: jakim@smc.samsung.co.kr; Tel: +82 2 3410 2470; Fax: +82 2 3410 0361
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Summary

Background and Objective

The effectiveness of the Cobra perilaryngeal airway as a routine airway device and as a conduit for tracheal intubation has not been prospectively studied to date. This study aimed to evaluate the Cobra perilaryngeal airway for its potential role in an emergency airway rescue, by analysing its use as a bridge to blind or fibre-optic-guided intubation.

Methods

In 49 patients, the procedure was carried out as follows: fibre-optic view through the Cobra perilaryngeal airway was assessed after the insertion of the Cobra perilaryngeal airway, then blind intubation through the Cobra perilaryngeal airway was attempted. After evaluating the success of blind intubation, fibre-optic-guided intubation was performed through the Cobra perilaryngeal airway. The endotracheal tube was removed after evaluating the success of fibre-optic-guided intubation, and then conventional laryngoscopy was carried out to evaluate the Cormack & Lehane grade and airway trauma.

Results

In all, 95.9% (47/49) of patients had adequate ventilation using the Cobra perilaryngeal airway; the success rates for the blind and fibre-optic-guided intubation were 36.2% and 83.0%, respectively. The patients were divided into two groups according to the fibre-optic view. Group 1 included patients with an obstructed view by an anterior grill of the Cobra perilaryngeal airway head, and a view of the anterior epiglottis (downfolded epiglottis) with or without a visible larynx (16/47, 34.0%). Group 2 included the remaining patients (31/47, 66.0%). The success rates of the blind and fibre-optic intubations were different between the two groups (blind intubation: 12.5% vs. 48.4%, fibre-optic intubation: 62.5% vs. 93.6%, P < 0.05). The success rates of blind and fibre-optic-guided intubations were not different according to the Cormack & Lehane grading (P > 0.05). 42.6% of patients had blood staining after removing the device and complications such as trauma and oedema were confirmed under direct laryngoscopy.

Conclusion

This study suggests that the Cobra perilaryngeal airway could be a useful airway device as a vehicle for fibre-optic-guided intubation; however, it needs caution against airway trauma.

Keywords

ANAETHESIA GENERALLARYNGEAL MASKS, Cobra perilaryngeal maskINTUBATION INTRATRACHEAL
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 10 , October 2007 , pp. 852 - 855
Copyright
Copyright © European Society of Anaesthesiology 2007

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Footnotes

*

This study does not have any financial relationship with any device companies.

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