Airway Educational Project

Medinfo Sites weblog

Are we ignoring this important issue? Will this change our practices in the future?

By •• Posted in Devices, SGA

In an upcoming issue of Acta Anaesthesiologica Scandinavica the following article will appear ( I am including the abstract). I must confess this concern about SGA’s -that perhaps should be extended to all of them- had not been on my radar screen for quite a while. Any comments?

“Exposure to anaesthetic trace gases during general anaesthesia: CobraPLA vs. LMA classic

Department of Anaesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria, Department of Anaesthesiology, University of Regensburg, Regensburg, Germany and Department of Internal Medicine I, Medical University of Vienna,Austria.

Background: To prospectively investigate the performance,sealing capacity and operating room (OR) staff exposure to waste anaesthetic gases during the use of the Cobra perilaryngeal airway (CobraPLA) compared with the laryngeal mask airway classic (LMA). Methods: Sixty patients were randomly assigned to the CobraPLA or the LMA group. Insertion time, number ofinsertion attempts and airway leak pressures were assessed after induction of anaesthesia. Occupational exposure to nitrous oxide (N2O) and Sevoflurane (SEV) was measured at the anaesthetists’ breathing zone and the patients’ mouth using a photoacoustic infrared spectrometer. Results: N2O waste gas concentrations differed significantly in the anaesthetist’s breathing zone (11.7-7.2 p.p.m. in CobraPLA vs. 4.1  4.3 p.p.m. in LMA,P50.03), whereas no difference could be shown in SEV concentrations. Correct CobraPLA positioning was possible in 28 out of 30 patients (more than one attempt necessary in five patients). Correct positioning of the LMA classic was possible in all 30 patients (more than one attempt in three patients). Peak airway pressure was higher in the CobraPLA group (16  3 vs. 14  2 cmH2O, P50.01). The average leak pressure of the CobraPLA was (24 +/- 4 cmH2O), compared with (20 +/-  4 cmH2O) of the LMA classic (Po0.001; all values means  SD). Conclusion: Despite higher airway seal pressures, the CobraPLA caused higher intraoperative N2O trace concentrations in the anaesthetists’ breathing zone. Accepted for publication 11 November 2009 The Acta Anaesthesiologica Scandinavica Foundation”

Leave a Reply - Comments are open to all Gatorlink users

Log in with your Gatorlink account to reply.

You can follow any responses to this entry through the RSS 2.0 feed.