Comparison of effects of classic LMA, cobraPLA and V-gel rabbit on QTc interval.

AIM: We aimed to compare the effects of three different supraglottic airway devices, the classic LMA, PLA, and V-gel, on hemodynamics and QTc in rabbits under general anesthesia. METHOD: The rabbits were divided into four groups: Group C (n=5) control group with no airway device used, Group L (n=5, classic LMA), Group P (n=5, CobraPLA) and Group V (n=5, V-gel-rabbit). Basal values of heart rate (HR), mean arterial pressure (MAP) and ECG for QTc interval were measured and the measurements were evaluated at 1, 5, 15, and 30 minutes after inserting the airway device RESULTS: The values of HR, MAP and QTc in Group V at minutes 1 and 5 were significantly different to those in Group L and Group P (p<0.05). DISCUSSION: The classic-LMA and cobraPLA cover a wide part of the perilaryngeal area with cuffs inflated to about 60 cmH2O of pressure resulting in mucosal compression. As V-gel rabbit does not have a cuff, it covers a smaller part of the laryngopharyngeal area, and thus does not cause mucosal compression, and the hemodynamic response is weaker. CONCLUSION: When comparing hemodynamic responses to other supraglottic airway devices, the response to V-gel rabbit is minimal and we consider that similar studies using the I-gel on humans are required (Fig. 5, Ref. 31).

Efficacy of the New Perilaryngeal Airway (CobraPLA™) Versus the Laryngeal Mask Airway (LMA™) to Improve Oropharyngeal Leak Pressure in Obese and Overweight Patients.

BACKGROUND: This study aimed to evaluate the applicability of Cobra perilaryngeal airway (Cobra PLA™) for obese patients under general anesthesia and also to compare the results with those of classic laryngeal mask airway (LMA™). MATERIALS AND METHODS: Seventy-three overweight and obese patients were included in this study. The patients were randomly assigned to LMA™ or Cobra PLA™ groups. Time required for intubation, successful intubation attempt, airway sealing pressure and incidence of complications including blood staining, sore throat and dysphagia were assessed and noted. RESULTS: Thirty-six and 37 patients were randomly allocated to LMA™ and Cobra PLA™ groups, respectively. Most patients were males and had Mallampati Class II airway in both groups. The first attempt and overall insertion success for Cobra PLA™ was significantly higher compared to LMA (P<0.05). Airway insertion was more successful (P = 0.027; 94% vs. 77%) with Cobra PLA™. Insertion times were similar with Cobra PLA™ and LMA™ (Cobra PLA™, 29.94±16.35s; LMA™, 27.00±7.88s). The oropharyngeal leak pressure in the Cobra PLA™ group (24.80±0.90 H2O) was significantly higher than that in LMA™ group (19±1 H2O, p<0.001). Sore throat was more frequent in the LMA™ group although it did not reach statistical significance (Fisher's exact test, P = 0.33). Blood staining on airway tube was seen in both groups with a higher incidence in the Cobra PLA™ group (Fisher's Exact test, P = 0.02). Incidence of dysphagia was not different between the two groups. CONCLUSION: CobraPLA™ was found to be safe with low complications. It provided better airway sealing with high rate of the first insertion success for use in obese and overweight patients. This study recommends the use of CobraPLA™ as a rescue device in emergency situations for obese and overweight patients.

The investigation of airway management capacity of v-gel and cobra-PLA in anaesthetised rabbits

PURPOSE: To evaluate the applicability and airway management capacity of v-gel(r) and Cobra PLA in rabbit anaesthesia during assisted (AV) or controlled ventilation (CV). METHODS: This study was carried out in 44 adult New Zealand white rabbit. Baseline arterial pH, PaCO2 and PaO2 values were recorded. Anaesthesia was induced with 5 mg/kg xylasine and 35 mg/kg ketamine HCI combination. AV rabbits were assigned as; control (CG-AV; n=5), LMA (LMA-AV; n=5), cobra PLA (PLA-AV; n=5) and v-gel (v-gelAV; n=5). Rabbits have CV were also assigned as; ET (ET-CV; n=6), LMA (LMA-CV; n=6), cobraPLA (PLA-CV; n=6) and v-gel (v-gelCV; n=6). All measurements were repeated 1st, 5th, 15th and 30th mins during anaesthesia. RESULTS: The less insertion time, number of attempt and complications are recorded in v-gel applied rabbits compared to other apparatus. For arterial pH values significant differences are recorded in especially at 15th and 30th min between groups of CV (p<0.005 or p<0.001). All groups had similar results with each other during anaesthesia for PaCO2 except for LMA-CV group. CONCLUSION: The v-gel may be used as airway device in rabbit anaesthesia undergoing AV or CV and also can be a suitable alternative to endotracheal tubes and laryngeal mask airway. .

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

BACKGROUND: Supraglottic airway devices play an important role in ophthalmic surgery. The flexible laryngeal mask airway (LMA™) is generally the preferred airway device. However, there are no studies comparing it with the Cobra perilaryngeal airway (CobraPLA™) in pediatric ophthalmic procedures. AIMS: To analyze the intraoperative device stability and ability to maintain normocarbia of CobraPLA™ and compare it to that with flexible LMA™. 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™ or the flexible LMA™ 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™ in comparison to flexible LMA™ (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™ group (28 ± 6.8 cm H(2)O) compared to the flexible LMA™ group (19.9 ± 4.5 cm H(2)O) (P < 0.001). Higher surgeon dissatisfaction (65.9%) was seen in the CobraPLA™ group. CONCLUSION: The high incidence of device displacement and surgeon dissatisfaction make CobraPLA™ a less favorable option than flexible LMA™ in ophthalmic surgery.

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

BACKGROUND: The Cobra Perilaryngeal Airway (CobraPLA) and the Laryngeal Mask 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.