A comparative study of the Cobra perilaryngeal airway and Proseal laryngeal mask airway during laparoscopic cholecystectomy / 대한마취과학회지

ABSTRACT

BACKGROUND: The Cobra Perilaryngeal Airway(TM) (Cobra PLA) and the Proseal Laryngeal Mask Airway(TM) (Proseal LMA) provide higher sealing pressures than the classic LMA. The authors compared the clinical effectiveness of these two airway types for controlled ventilation during laparoscopic cholecystectomy. METHODS: One hundred and twenty patients (ASA physical status I-II, aged 18-65 yrs) scheduled for laparoscopic cholecystectomy were randomly allocated for airway management with the Cobra PLA or the Proseal LMA. Anesthesia was induced and maintained with propofol and remifentanil using a target controlled infusion system. Insertion characteristics, anatomical positions, airway adequacies, ventilation efficacies, degrees of gastric distension, and postoperative adverse events (sore throat, dysphagia, and dysphonia) were noted. RESULTS: The number of insertion attempts, insertion times, airway sealing pressure, and airway positions were similar in the two groups. In one Cobra PLA patient, tracheal intubation was needed due to inadequate ventilation before pneumoperitoneum. During pneumoperitoneum, oxygenation and ventilation were optimal in all patients in both groups, and degrees of gastric distension were similar. Furthermore, no differences were found in terms of the incidences of adverse effects. CONCLUSIONS: Cobra PLA and Proseal LMA were found to have similar insertion characteristics and both provided adequate airways and effective ventilation during laparoscopic cholecystectomy.