Comparison of laryngeal mask airway, cobra perilaryngeal airway and face mask in children airway management

Purpose : Our study aimed to compare the effects of laryngeal mask airway(LMA), face mask and Cobra perilaryngeal airway (Cobra PLA) in airway managementof spontaneously ventilated pediatric patients undergoing elective inguinal surgeryMaterials and methods : The ethics committee and parental consent, ASA I-IIpatients undergoing elective inguinal surgery, 90 cases between the ages of 1-14enrolled in the study. Patients were randomly divided into 3 groups. Group I laryngealmask airway, Group II Cobra perilaryngeal airway, group III was determined as the facemask. Get together with parents to the operating room anesthesia to patients, using theappropriate face mask, the sevoflurane concentration of 6-8%, 50% nitrous oxide andoxygen with a mixture of 50% was achieved. Intravenously to patients with ageappropriateintravenous cannulation after providing adequate depth of anesthesia, Group1 and 2, according to the weight of children of supraglottic airway devices wereinserted. It was recorded that the duration and number of insertion provided by theanesthesiologist.Hemodynamic parameters of patients, systolic blood pressure, diastolic bloodpressure, heart rate and peripheral arterial oxygen saturation were recordedpreoperatively, after induction, after the instrumentation, peroperative 5-10-15 and 30minutes. Also, the inhalated sevoflurane concentration, end-tidal sevofluraneconcentration, tidal volume, plateau pressure, peak inspiratory pressure, positive endexpiratory pressure and end tidal carbon dioxide levels were recorded after induction,the airway attempts later, peroperative 5-10-15 and 30 minutes. No intraoperative orpostoperative complications were observed in all cases,Results: Hemodynamic parameters in all measurements in terms of statisticaldifference (p> 0.05). End tidal sevoflurane concentration was found to be similar in allgroups (p> 0.05). To ensure safe airway time spent that recorded in Group 2 less thanthe other groups were statistically significant (p <0.05). Instrumentation on the first trysuccess was 63.3% in Group 1 and Group 2, 83.3% in determining the statisticaldifference (p> 0.05). Tidal volume measurements were similar between the groups (p>0.05). Positive end expiratory pressure, plateau and peak inspiration pressure werestatistically in Group 2 lower than Group 1 and Group 3 (p <0.05). ETCO2 values werehigher in group 2 than the other groups (p <0.05). Complications were evaluated, nosignificant differences between the three groups (p> 0.05).Conclusion: As a result of airway safety and possible complications withrespect to LMA and Cobra can be an alternative to face mask. Cobra PLA wouldprovide lower airway pressure than the LMA and quick and easy way by placing.Key words: Cobra perilaryngeal airway, airway management, Laryngeal maskairway