Pusch F, Wildling E, Freitag H, Goll V, Hoerauf K, Weinstabl C
Clinical Department of Anesthesia and General Intensive Care, University of Vienna, Austria.
Wien Klin Wochenschr. 2001 Jan 15;113(1-2):33-7.
The cuffed oropharyngeal airway (COPA), a modified Guedel-type airway with a cuff at the distal end, has recently been introduced into anesthetic practice. The aim of this study was to compare the COPA with the well established laryngeal mask airway (LMA). Special consideration was granted to the difficult airway.
Two hundred and fifty-two women of ASA class I or II undergoing elective gynecological or breast surgery under general anesthesia were randomly assigned to either cuffed oropharyngeal or laryngeal mask airway management. Insertion and removal of the device, airway maintenance throughout the procedure, and postoperative course and complications were assessed.
A patent airway was obtained with either device in all patients. Global first-time success rates for insertion were similar in the two study groups. Initial failure of correct placement occurred more frequently in the COPA as compared to the LMA group if the interincisor gap was < 5 cm and mandibular protrusion impossible (p < 0.01). Neither thyromental distance nor Mallampati scores nor body mass index (BMI) were of relevance for insertion success. The incidence of postoperative complaints and of mucosal injuries was significantly higher with the LMA.
On the whole, high overall success and low complication rates render COPA and LMA equally suitable for routine anesthetic airway management.
带套囊的口咽通气道（COPA）是一种改良的古德尔型通气道，其远端带有套囊，最近已被引入麻醉实践。本研究的目的是将COPA与成熟的喉罩气道（LMA）进行比较。对困难气道给予了特别关注。
252例ASA I或II级接受全身麻醉下择期妇科或乳腺手术的女性被随机分配接受带套囊口咽通气道或喉罩气道管理。评估了装置的插入和移除、整个手术过程中的气道维持以及术后病程和并发症。
所有患者使用任何一种装置均获得了通畅气道。两个研究组的总体首次插入成功率相似。如果门齿间距<5 cm且无法下颌前突，则与LMA组相比，COPA组正确放置的初始失败发生率更高（p<0.01）。甲状软骨至颏下距离、马兰帕蒂评分以及体重指数（BMI）与插入成功均无关。LMA术后不适和黏膜损伤的发生率显著更高。
总体而言，高总体成功率和低并发症发生率使COPA和LMA同样适用于常规麻醉气道管理。
