An evaluation of the cuffed oropharyngeal airway for elective pediatric anesthesia³☆

Abstract 

Study Objective: To evaluate the usefulness in pediatric patients of the cuffed oropharyngeal airway (COPA), an airway device with an inflatable cuff around its distal portion, and which provides airway patency in the majority of anesthetized adult patients.

Design: Prospective evaluation.

Setting: Pediatric operating room of a tertiary-care medical center.

Patients: 50 anesthetized ASA physical status I pediatric patients, under 6 yr of age undergoing elective surgery.

Interventions: Patients were fitted with a size 7 COPA placed following anesthetic induction. If an adequate airway was not obtained, a size 8 COPA was placed. If an adequate airway was not obtained despite repositioning the size 8, the COPA was considered failed.

Measurements and Main Results: The ease of insertion and ability to manage the airways were evaluated. Complications were evaluated on insertion, during maintenance, and upon awakening. The ability to positive pressure ventilate via the COPA was assessed. The size 7 COPA obtained an initial fit in 38 (76%) of the patients. Nine patients were managed with a size 8 COPA. The COPA was unsuccessful in 3 (6%) patients. Laryngospasm occurred in three patients. Blood was not visible on any of the COPAs. Positive pressure ventilation was achieved with 30 ± 7 cm H₂O pressure.

Conclusions: The results using the COPA in pediatric patients seem to parallel the experience of using larger sizes in adult patients.

Keywords:  Airway management, anesthesia: general, pediatric

• 3 Research performed in the Department of Anesthesiology, Baystate Medical Center.