In Reply:—

We thank Drs. Alfery and Szmuk for their positive comments about our article.1In many countries, the use of extraglottic devices equals that of tracheal intubation. It is imperative that all new extraglottic devices undergo carefully conducted clinical trials to determine their safety and efficacy versus  the current standard, the laryngeal mask airway, which has been extensively used and studied.2Data that has been collected about one extraglottic device need not necessarily apply to another. Our study was probably one of many factors that resulted in the decision to redesign the CobraPLA (Engineered Medical Systems Inc., Indianapolis, IN). The new version, the CobraPLUS, seems to be easier to insert and the integral temperature probe is a nice feature, but this requires confirmation. That industry responded to our article is encouraging.

*Catharina Hospital–Brabant Medical School, Eindhoven, The Netherlands.


van Zundert A, Al-Shaikh B, Brimacombe J, Koster J, Koning D, Mortier E: Comparison of three disposable extraglottic airway devices in spontaneously breathing adults: The LMA-Unique ™, the Soft Seal laryn-geal mask, and the Cobra peripharyngeal airway. Anesthesiology 2006; 104:1165–9
Brimacombe JR: Laryngeal Mask Anesthesia: Principles and Practice, 2nd edition. Philadelphia, Saunders, 2005