A COMPARISON OF THE LARYNGEAL MASK AIRWAY AND CUFFED OROPHARYNGEAL AIRWAY IN ANESTHETIZED ADULT PATIENTS

We compared the cuffed oropharyngeal airway (COPA) with the laryngeal mask airway (LMA) in 120 anesthetized adult patients. We compared 1) p lacement success rates, 2) airway interventional requirements, 3) airw ay stability in different head/neck positions, 4) cardiorespiratory to lerance, and 5) intra- and postoperative adverse events/symptoms. A st andardized anesthesia protocol was followed by four anesthesiologists experienced with both devices. Observational data were validated by in dependent analysis of continuous video recordings. Postoperative inter views were double-blind to the device used. The LMA had a more frequen t success rate than COPA (97% vs 55%, P < 0.00001), an overall higher success rate (100% vs 83%; P = 0.001), a shorter time to achieve an ef fective airway (49 vs 188 s; P < 0.00001), a higher oropharyngeal leak pressure (21 vs 16 cm H2O; P = 0.003), and a fewer number of chin lif t airway interventions required (0.1% vs 42%; P < 0.00001). When compa ring mean tidal volumes in different head/neck positions to assess air way stability, the quality of airway was unchanged in 98% patients wit h the LMA and 54% with the COPA (P < 0.00001). The incidences of intra operative adverse events were similar. On removal, blood was detected more often on the COPA (3% vs 14%; P = 0.04). In the late postoperativ e period, more patients complained of adverse symptoms with the COPA t han with the LMA (26% vs 57%; P = 0.001). Late postoperative symptoms occurred more frequently with the COPA (0.87 vs 0.34; P = 0.003). Ther e was more late postoperative sore throat (14% vs 36%; P = 0.0003) and morejaw/neck pain (12% vs 26%; P = 0.0008) in patients managed with t he COPA. This study demonstrates that the LMA offers advantages over t he COPA in most technical aspects of airway management and in terms of postoperative morbidity. Implications: In this randomized, prospectiv e study, we compared the laryngeal mask airway and the cuffed orophary ngeal airway in anesthetized patients. The laryngeal mask airway offer s advantages in most technical aspects of airway management and in ter ms of postoperative morbidity.