Videolaryngoscope versus Macintosh laryngoscope for tracheal intubation in adults with obesity: A systematic review and meta-analysis

Videolaryngoscopy has become more common since the 2000s. Despite several anecdotal reports in the literature, it remains unclear whether videolaryngoscopy is superior to direct Macintosh laryngoscopy for tracheal intubation in adults with obesity. This systematic review and meta-analysis focused on...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2018-02, Vol.44, p.69-75
Main Authors: Hoshijima, Hiroshi, Denawa, Yohei, Tominaga, Asako, Nakamura, China, Shiga, Toshiya, Nagasaka, Hiroshi
Format: Article
Language:English
Subjects:
Adult
Airway management
Bias
Body mass index
Glottis - diagnostic imaging
Humans
Intubation
Intubation, Intratracheal - adverse effects
Intubation, Intratracheal - instrumentation
Intubation, Intratracheal - methods
Laryngoscopes
Laryngoscopy - instrumentation
Laryngoscopy - methods
Meta-analysis
Obesity
Obesity - complications
Obesity patients
Studies
Success
Systematic review
Time Factors
Treatment Outcome
Video-Assisted Surgery - instrumentation
Video-Assisted Surgery - methods
Videolaryngoscopes
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Summary:Videolaryngoscopy has become more common since the 2000s. Despite several anecdotal reports in the literature, it remains unclear whether videolaryngoscopy is superior to direct Macintosh laryngoscopy for tracheal intubation in adults with obesity. This systematic review and meta-analysis focused on prospective randomised trials comparing videolaryngoscopes with the Macintosh laryngoscope for tracheal intubation in adults with obesity. Systematic review, Meta-analysis Operating room, Obesity patients Data on success rate, intubation time, and glottic visualisation during tracheal intubation were extracted from the identified studies. In a subgroup analysis, we also compared the parameters for videolaryngoscopes with a tracheal tube guide channel and those without a tracheal tube guide channel. Data from individual trials were combined, and the DerSimonian and Laird random-effect model was used to calculate either the pooled relative risk (RR) or the weighted mean difference (WMD) as well as the corresponding 95% confidence intervals (CI). Eleven articles describing 13 trials met the inclusion criteria. The performance of videolaryngoscopes was superior to that of the Macintosh laryngoscope for all outcomes. (Success rate; RR=1.11, 95% CI 1.04 to 1.18, p=0.001, I2=63%, Intubation time; WMD=−16.1, 95% CI −31.1 to −1.10, p=0.04, I2=97%, Glottic visualisation; RR=1.19, 95% CI 1.09 to 1.30, p
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2017.11.008