Efficacy of the New Perilaryngeal Airway (CobraPLA™) Versus the Laryngeal Mask Airway (LMA™) to Improve Oropharyngeal Leak Pressure in Obese and Overweight Patients

Background: This study aimed to evaluate the applicability of Cobra perilaryngeal airway (Cobra PLATM) for obese patients under general anesthesia and also to compare the results with those of classic laryngeal mask airway (LMATM). Materials and Methods: Seventy-three overweight and obese patients were included in this study. The patients were randomly assigned to LMATM or Cobra PLATM groups. Time required for intubation, successful intubation attempt, airway sealing pressure and incidence of complications including blood staining, sore throat and dysphagia were assessed and noted. Results: Thirty-six and 37 patients were randomly allocated to LMATM and Cobra PLATM groups, respectively. Most patients were males and had Mallampati Class II airway in both groups. The first attempt and overall insertion success for Cobra PLATM was significantly higher compared to LMA (P < 0.05). Airway insertion was more successful (P = 0.027; 94% vs. 77%) with Cobra PLATM. Insertion times were similar with Cobra PLATM and LMA™ (Cobra PLATM, 29.94±16.35s; LMA™, 27.00±7.88s). The oropharyngeal leak pressure in the Cobra PLATM group (24.80±0.90 H2O) was significantly higher than that in LMA™ group (19±1 H2O, p < 0.001). Sore throat was more frequent in the LMA™ group although it did not reach statistical significance (Fisher’s exact test, P = 0.33). Blood staining on airway tube was seen in both groups with a higher incidence in the Cobra PLATM group (Fisher’s Exact test, P = 0.02). Incidence of dysphagia was not different between the two groups. Conclusion: CobraPLA™ was found to be safe with low complications. It provided better airway sealing with high rate of the first insertion success for use in obese and overweight patients. This study recommends the use of CobraPLA™ as a rescue device in emergency situations for obese and overweight patients.