Boufflers E, Maslowski D, Menu H, Guermouche T, Theeten G, Beague D, Reyford H, Krivosic-Horber R
Département d'anesthésie-réanimation chirurgicale 1, CHRU, Lille, France.
Ann Fr Anesth Reanim. 1998;17(3):206-9. doi: 10.1016/s0750-7658(98)80001-4.
To assess the performance of the COPA device during general anaesthesia.
Prospective, clinical, open study.
Eighty patients scheduled for short elective surgical procedures under general anaesthesia not requiring tracheal intubation.
After premedication (midazolam, atropine), anaesthesia was induced with propofol (154 +/- 40 mg = 2.47 +/- 0.8 mg.kg-1) and alfentanil (1.14 +/- 0.43 mg). The COPA device was inserted in a fashion similar to a Guedel airway device. The device was evaluated on the following criteria: correct choice of COPA size, ease of insertion, ability to obtain or maintain patent airway. Adverse reactions were noted, such as coughing, nausea, regurgitation, inhalation, and sore throat. The overall rating of the COPA as a "hand free device" was evaluated on the basis of excellent, good, fair, and poor.
Insertion of the device was easy and in 70 cases successful on the first attempt. Jaw thrust on head tilt was necessary in half the cases. No patient necessitated intubation because of hypoxaemia or airway obstruction. Adverse reactions occurred in few cases and consisted of sore throat (always moderate) in 10% of the cases. COPA was evaluated as excellent or good in 80% of the cases.
COPA is a convenient device for airway management in fasting patients undergoing general anaesthesia for elective surgery in the supine position, in whom tracheal intubation is not indicated.
评估COPA装置在全身麻醉期间的性能。
前瞻性、临床、开放性研究。
80例计划在全身麻醉下进行无需气管插管的短期择期手术的患者。
在给予术前用药(咪达唑仑、阿托品)后,用丙泊酚(154±40mg = 2.47±0.8mg·kg-1)和阿芬太尼(1.14±0.43mg)诱导麻醉。以类似于Guedel气道装置的方式插入COPA装置。根据以下标准对该装置进行评估:COPA尺寸的正确选择、插入的难易程度、获得或维持气道通畅的能力。记录不良反应,如咳嗽、恶心、反流、吸入和咽痛。根据优、良、中、差对COPA作为“免手操作装置”进行总体评分。
该装置插入容易,70例首次尝试成功。半数病例需要在头部后仰时进行下颌前推。没有患者因低氧血症或气道阻塞而需要插管。少数病例出现不良反应,10%的病例出现咽痛(均为中度)。80%的病例中COPA被评为优或良。
对于仰卧位接受择期手术全身麻醉的禁食患者,在无需气管插管的情况下,COPA是一种方便的气道管理装置。