A prospective randomized trial comparing the cuffed oropharyngeal airway (COPA) with the laryngeal mask for elective minor surgery in female patients

Objective: The cuffed oropharyngeal airway (COPA), a modified Guedel-type a irway with a cuff at the distal end, has recently been introduced into anes thetic practice. The aim of this study was to compare the COPA with the wel l established laryngeal mask airway (LMA). Special consideration was grante d to the difficult airway. Patients and methods: Two hundred and fifty-two women of ASA class I or II undergoing elective gynecological or breast surgery under general anesthesi a were randomly assigned to either cuffed oropharyngeal or laryngeal mask a irway management. Insertion and removal of the device, airway maintenance t hroughout the procedure, and postoperative course and complications were as sessed. Results: A patent airway was obtained with either device in all patients. G lobal first-time success rates for insertion were similar in the two study groups. Initial failure of correct placement occurred more frequently in th e COPA as compared to the LMA group if the interincisor gap was <5 cm and m andibular protrusion impossible (p<0.01). Neither thyromental distance nor Mallampati scores nor body mass index (BMI) were of relevance for insertion success. The incidence of postoperative complaints and of mucosal injuries was significantly higher with the LMA. Conclusion: On the whole, high overall success and low complication rates r ender COPA and LMA equally suitable for routine anesthetic airway managemen t.