Use of cuffed oropharyngeal vs laryngeal mask airway in elderly patients

Purpose: This study was designed to compare the new cuffed oropharyngeal ai rway (COPA) to the laryngeal mask airway (LMA) in elderly patients. Methods: In a randomized, controlled study, 80 patients, age greater than o r equal to 65, ASA I-Iii, undergoing urology procedures, were managed with either COPA or LMA. Propofol requirements for insertion of the devices, eas e of insertion and removal. airway manipulations, mean arterial pressure, h eart rate. PETCO2, SpO(2), peak inspiratory pressure, selection of the appr opriate size of the device and leaks, fibreoptic Visualization of larynx an d complications were studied. Results: There were more airway manipulations in the COPA group than in the LMA group (40% and 5% respectively) whereas PETCO2 was higher in the LMA g roup (P <0.05). In 60% of COPA patients the vocal cords could not be visual ized but ventilation was adequate in all hut two cases. Postoperative sore throat occurred in 20% of patients with LMA vs 10% with COPA). Bloody secretions on the device were present in two patients managed with LMA. Conclusion: In elderly patients COPA required more airway manipulations tha n the LMA. Laryngeal mask airway caused more sore throats, but was better f or fibreoptic visualisation of the larynx. Both are excellent options when intubation is not indicated/desired.