An evaluation of the cuffed oropharyngeal airway for elective pediatric anesthesia

Study Objective: To evaluate the usefulness in pediatric patients of the cu ffed oropharyngeal airway (COPA), an airway device with an inflatable cuff around its distal portion, and which provides airway patency in the majorit y of anesthetized adult patients. Design: Prospective evaluation. Setting: Pediatric operating room of a tertiary-care medical center. Patients: 50 anesthetized ASA physical status I pediatric patients, under 6 yr of age undergoing elective surgery. Interventions: Patients were fitted with a size 7 COPA placed following ane sthetic induction. If an adequate airway was not obtained, a size 8 COPA wa s placed. If an adequate airway was not obtained despite repositioning the size 8, the COPA was considered failed. Measurements and Main Results: The case of insertion and ability to manage the airways were evaluated. Complications were evaluated on insertion, duri ng maintenance, and upon awakening. The ability to positive pressure ventil ate via the COPA was assessed. The size 7 COPA obtained an initial fit in 3 8 (76%) of the patients. Nine patients were managed with a size 8 COPA. The COPA was unsuccessful in 3 (6%) patients. Laryngospasm occurred in three p atients. Blood was not visible on any of the COPAs. Positive pressure venti lation was achieved with 30 +/- 7 cm H2O pressure. Conclusions: The results using the COPA in pediatric patients seem to parallel the experience of us ing larger sizes in adult patients. (C) 2000 by Elsevier Science Inc.