Cobra-PLA provides higher oropharyngeal leak pressure than LMA-Classic and LMA-Unique: A meta-analysis with 22 studies

Cobra Perilaryngeal Airway (Cobra-PLA) is a relatively new single-use supraglottic device employed during general anesthesia. This meta-analysis includes randomized controlled trials (RCTs) yielding extensive comparison results among Cobra-PLA, Laryngeal Mask Airway (LMA)-Classic, and LMA-Unique. Two authors performed searches in EMBASE, CENTRAL, PubMed, and ScienceDirect to identify RCTs that compared Cobra-PLA with LMA-Classic and with LMA-Unique in patients undergoing general anesthesia. Both random- and fixed-effects models were used. Begg's funnel plot was used to evaluate publication bias. Twenty-two RCTs with a total of 1845 patients were included. Cobra-PLA offered significantly higher oropharyngeal leak pressure than LMA-Classic [mean difference (MD) = 3.56 (1.56, 5.55), P = .0005] and LMA-Unique [MD = 4.44 (2.12, 6.76), P = .0002]. First-insertion success rate, ease of insertion, insertion time, and reported complications among Cobra-PLA, LMA-Classic, and LMA-Unique were similar. Compared with the commonly used LMA-Classic and LMA-Unique, Cobra-PLA provides superior airway sealing.