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Randomised Comparison of the Classic Laryngeal Mask Airway™ with the Cobra Perilaryngeal Airway™ during Anaesthesia in Spontaneously Breathing Adult Patients

We tested the hypothesis that the Cobra Perilaryngeal Airway (PLA) with its high volume low-pressure cuff would provide superior airway leakage pressure compared with the Classic Laryngeal Mask Airway (LMA) in spontaneously breathing adult patients. Ninety consecutive adult patients were randomly allocated to receive one of these two supralaryngeal devices. The airway leakage pressure was higher for the PLA compared with the LMA (22±9 cmH2O vs. 18±6 cmH2O; P <0.05). The mean airway device intracuff pressure was lower for the PLA compared to the LMA (36.1±15.2 mmHg vs. 86.3±25.3 mmHg P <0.0001). The time required to achieve successful insertion was greater for the PLA compared with the LMA (39±21 seconds vs. 27±10 seconds; P <0.005). The number of attempts required to achieve successful insertion and the incidence of postoperative complications were similar in both groups. The findings suggest that the PLA provides a superior airway seal at a lower intracuff pressure compared to the LMA. However, the time for successful insertion may be increased.