Key result
Insertion of the Cobra perilaryngeal airway by novice anaesthesiologists yielded a similar success rate to the laryngeal mask airway Supreme (89% vs 91%; P=0.75), but was rated easier to insert.
Why the study?
Supraglottic airway devices play an important role in airway management, but the insertion success rate of Cobra perilaryngeal airway compared with laryngeal mask airway Supreme by novice anaesthesiologists was unstudied.
Does Cobra perilaryngeal airway (C-PLA) improve the success rate of insertion compared to laryngeal mask airway Supreme (S-LMA) when performed by novice anaesthesiologists in adult patients undergoing elective surgery?
RCT (n=112)
randomised
No
Does Cobra perilaryngeal airway (C-PLA) improve the success rate of insertion compared to laryngeal mask airway Supreme (S-LMA) when performed by novice anaesthesiologists in adult patients undergoing elective surgery?
Absolute Event Rate: 89% vs 91%
p-value: p=0.75
C-PLA and S-LMA have similar insertion success rates and times when used by novice anesthesiologists, although C-PLA is perceived as easier to insert.
C-PLA does not improve novice insertion success over S-LMA; confirms comparable performance with ease advantage for C-PLA.
Background and Aim: Because of its simplicity of insertion, supraglottic airway (SGA) plays an important role in airway management. This study was planned to compare success rate within two attempts at correct placement of Cobra perilaryngeal airway (C-PLA) with laryngeal mask airway Supreme (S-LMA) by novice anaesthesiologists. Secondary objectives included the comparison of time to insertion, ease of insertion and incidence of complications with the device. Methods: The trial was approved by the Institutional Review Board and registered with the Clinical Trials Registry-India (CTRI/2014/08/004913). Fourteen eligible and consenting novice anaesthesiologists were included. Each trainee had to insert each SGA for 5 successful times on the Laerdal airway trainer. After obtaining informed consent, 112 adult patients undergoing elective surgery were randomised to the anaesthesiologists and the SGA device. Induction of general anaesthesia was standardised. Only 2 attempts at insertion of SGA were allowed. Ease of insertion by novices was recorded using a numerical rating scale (NRS) 1 to 10 (10 = easiest). Data were entered into IBM SPSS software version 21.0 (IBM, NY, USA). Categorical data were compared using Chi-square test, while scores were analysed using Mann-Whitney test. Results: There was no difference in success rate between S-LMA (91%) and C-PLA (89%) (P = 0.75). Median time (interquartile range) of insertion for S-LMA was 30 (25–34) seconds and C-PLA was 29 (25–32) seconds (P = 0.53). The incidence of complications was similar for both devices. Novices rated insertion of C-PLA NRS score of 8 (7–9) significantly easier than S-LMA NRS score 7 (5–9) (P = 0.0005). Conclusion: Although the success rate of insertion and time to insertion of C-PLA is similar to S-LMA, novices found C-PLA easier to insert.
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Mantri et al. (2020) conducted an RCT in Elective surgery (n=112). Cobra perilaryngeal airway (C-PLA) vs. Laryngeal mask airway Supreme (S-LMA) was evaluated on Success rate within two attempts at correct placement (p=0.75). Insertion of the Cobra perilaryngeal airway by novice anaesthesiologists yielded a similar success rate to the laryngeal mask airway Supreme (89% vs 91%; P=0.75), but was rated easier to insert.
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