Nam Sang Beom, Shim Yon Hee, Kim Min Soo, You Young Chul, Lee Youn-Woo, Han Dong Woo, Lee Jong Seok
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2006 Dec 31;47(6):799-804. doi: 10.3349/ymj.2006.47.6.799.
The CobraPLA (CPLA) is a relatively new supraglottic airway device that has not been sufficiently investigated. Here, we performed a prospective observational study to evaluate the efficacy of the CPLA during controlled ventilation. In 50 anesthetized and paralyzed patients undergoing elective surgery a CPLA was inserted and inflated to an intracuff pressure of 60 cm H2O. The success rate of insertion upon the first attempt was 82% (41/50), with a mean insertion time of 16.3 +/- 4.5 seconds. The adequacy of ventilation was assessed by observing the end tidal CO2 waveform, movement of the chest wall, peak airway pressure (13.5 cm H2O), and leak fraction (4%). We documented the airway sealing pressure (22.5 cm H2O) and noted that the the site of gas leaks at that pressure were either at the neck (52%), the abdomen (46%), or both (2%). In 44 (88%) patients, the vocal cords were visible in the fiberoptic view through the CPLA. There was no gastric insufflation during the anesthesia. Respiratory and hemodynamic parameters remained stable during CPLA insertion. Postoperative blood staining of CPLA was minimal, occurring in 22% (11/50) of patients. Mild and moderate throat soreness was reported in 44% (22/50) and 4% (2/50) of patients, respectively. Lastly, mild dysphonia was observed in 6% (3/50) of patients and mild dysphagia in 10% (5/50) of patients. Our results indicated that the CPLA is both easy to place and allows adequate ventilation during controlled ventilation.
CobraPLA(CPLA)是一种相对较新的声门上气道装置,尚未得到充分研究。在此,我们进行了一项前瞻性观察研究,以评估CPLA在控制通气期间的有效性。在50例接受择期手术的麻醉和麻痹患者中,插入CPLA并将其充气至套囊内压力为60 cm H2O。首次尝试插入的成功率为82%(41/50),平均插入时间为16.3±4.5秒。通过观察呼气末二氧化碳波形、胸壁运动、气道峰值压力(13.5 cm H2O)和漏气率(4%)来评估通气的充分性。我们记录了气道密封压力(22.5 cm H2O),并注意到在该压力下气体泄漏的部位要么在颈部(52%)、腹部(46%),要么两者都有(2%)。在44例(88%)患者中,通过CPLA在纤维喉镜视野中可见声带。麻醉期间没有胃胀气。CPLA插入过程中呼吸和血流动力学参数保持稳定。CPLA术后血染情况极少,22%(11/50)的患者出现这种情况。分别有44%(22/50)和4%(2/50)的患者报告有轻度和中度咽痛。最后,6%(3/50)的患者观察到轻度发音障碍,10%(5/50)的患者观察到轻度吞咽困难。我们的结果表明,CPLA易于放置,并且在控制通气期间能够提供充分的通气。