Comparison of the cuffed oropharyngeal airway and laryngeal mask airway in spontaneous breathing anesthesia

Yung Wei Hsu, M. H. Pan, C. J. Huang, C. R. Cheng, K. H. Wu, T. T. Wei, Chien-Tsu Chen

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background : The cuffed oropharyngcal airway (COPA) is a modified Guedel airway with a cuff at its distal end and a standard 15 mm connector at its proximal end. This study was performed to determine if the COPA would offer any advantage over the laryngcal mask airway (LMA). Methods : Eighty ASA class I to II adult patients scheduled for short elective procedures (less than 1 h) were randomly allocated into two groups. All patients were given atropine 0.01 mg/kg, fentanyl 2 μg/kg and propofol 2 mg/kg intravenously for induction of anesthesia. The COPA or LMA was inserted following the loss of eyelash reflex. If the jaw was not relaxed enough for insertion of a COPA or LMA, succinylcholine 1 mg/kg was given to facilitate the insertion. When correctly positioned, the cuff was immediately inflated with an appropriate volume. Gentle positive pressure ventilation was applied before spontaneous breathing resumed. Capnography was used to assess the patency of the airway. Anesthesia was maintained with isoflurane-N2O-O2 until the end of surgery. The success rate, vital signs, and adverse events were evaluated and compared. Results : The success rate in the LMA group (95%) was higher than the COPA group (85%). The increase in circulatory response after the LMA insertion was greater than that after the COPA insertion (P < 0.05). Nine patients (22.5%) in the LMA group needed succinylcholine to facilitate insertion compared with only two patients (5%) in the COPA group. Additional manipulation was frequently (57.5%) needed after inserting the COPA to maintain the patency of the airways, but none needed so in the LMA group. Two patients had laryngospasms upon removal of the LMA, but none had laryngospasm in the COPA group. The incidence of sore throat in the LMA group was higher than in the COPA group (18% vs. 10%). Conclusions : We demonstrated that the COPA could be easily inserted without the need of muscle relaxants in most patients. But the COPA needed airway intervention to provide an effective airway in most patients. Compared with the LMA, the COPA caused less stimulation than the LMA.

Original languageEnglish
Pages (from-to)187-192
Number of pages6
JournalActa Anaesthesiologica Sinica
Volume36
Issue number4
Publication statusPublished - Dec 1 1998
Externally publishedYes

Fingerprint

Laryngeal Masks
Masks
Respiration
Anesthesia
Laryngismus
Succinylcholine
Capnography
Eyelashes
Positive-Pressure Respiration
Pharyngitis
Vital Signs
Isoflurane
Fentanyl
Propofol
Jaw
Atropine
Reflex

Keywords

  • Anesthesia
  • Laryngeal mask
  • Ompharyiix

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Hsu, Y. W., Pan, M. H., Huang, C. J., Cheng, C. R., Wu, K. H., Wei, T. T., & Chen, C-T. (1998). Comparison of the cuffed oropharyngeal airway and laryngeal mask airway in spontaneous breathing anesthesia. Acta Anaesthesiologica Sinica, 36(4), 187-192.

Comparison of the cuffed oropharyngeal airway and laryngeal mask airway in spontaneous breathing anesthesia. / Hsu, Yung Wei; Pan, M. H.; Huang, C. J.; Cheng, C. R.; Wu, K. H.; Wei, T. T.; Chen, Chien-Tsu.

In: Acta Anaesthesiologica Sinica, Vol. 36, No. 4, 01.12.1998, p. 187-192.

Research output: Contribution to journalArticle

Hsu, Yung Wei ; Pan, M. H. ; Huang, C. J. ; Cheng, C. R. ; Wu, K. H. ; Wei, T. T. ; Chen, Chien-Tsu. / Comparison of the cuffed oropharyngeal airway and laryngeal mask airway in spontaneous breathing anesthesia. In: Acta Anaesthesiologica Sinica. 1998 ; Vol. 36, No. 4. pp. 187-192.
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abstract = "Background : The cuffed oropharyngcal airway (COPA) is a modified Guedel airway with a cuff at its distal end and a standard 15 mm connector at its proximal end. This study was performed to determine if the COPA would offer any advantage over the laryngcal mask airway (LMA). Methods : Eighty ASA class I to II adult patients scheduled for short elective procedures (less than 1 h) were randomly allocated into two groups. All patients were given atropine 0.01 mg/kg, fentanyl 2 μg/kg and propofol 2 mg/kg intravenously for induction of anesthesia. The COPA or LMA was inserted following the loss of eyelash reflex. If the jaw was not relaxed enough for insertion of a COPA or LMA, succinylcholine 1 mg/kg was given to facilitate the insertion. When correctly positioned, the cuff was immediately inflated with an appropriate volume. Gentle positive pressure ventilation was applied before spontaneous breathing resumed. Capnography was used to assess the patency of the airway. Anesthesia was maintained with isoflurane-N2O-O2 until the end of surgery. The success rate, vital signs, and adverse events were evaluated and compared. Results : The success rate in the LMA group (95{\%}) was higher than the COPA group (85{\%}). The increase in circulatory response after the LMA insertion was greater than that after the COPA insertion (P < 0.05). Nine patients (22.5{\%}) in the LMA group needed succinylcholine to facilitate insertion compared with only two patients (5{\%}) in the COPA group. Additional manipulation was frequently (57.5{\%}) needed after inserting the COPA to maintain the patency of the airways, but none needed so in the LMA group. Two patients had laryngospasms upon removal of the LMA, but none had laryngospasm in the COPA group. The incidence of sore throat in the LMA group was higher than in the COPA group (18{\%} vs. 10{\%}). Conclusions : We demonstrated that the COPA could be easily inserted without the need of muscle relaxants in most patients. But the COPA needed airway intervention to provide an effective airway in most patients. Compared with the LMA, the COPA caused less stimulation than the LMA.",
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