Supraglottic airway devices vs tracheal intubation in children: a quantitative meta‐analysis of respiratory complications. Issue 10 (30th July 2014)

• Record Type: Journal Article
• Authors: Luce, Virginie; Harkouk, Hakim; Brasher, Christopher; Michelet, Daphné; Hilly, Julie; Maesani, Matthieu; Diallo, Thierno; Mangalsuren, Nyamjargal; Nivoche, Yves; Dahmani, Souhayl; Lerman, Jerrold
• Is Part Of: Paediatric anaesthesia. Volume 24:Issue 10(2014)
• Page Start: 1088
• Page End: 1098
• Publication Date: 2014-07-30
• Subjects: Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.12495
• Languages: English
• ISSNs: 1155-5645

Abstract

<abstract abstract-type="main" id="pan12495-abs-0001"> <title>Summary</title> <sec id="pan12495-sec-0001" sec-type="section"> <title>Background</title> <p>Rate of perioperative respiratory complications between tracheal intubation (TI) and laryngeal mask airway remains unclear during pediatric anesthesia.</p> </sec> <sec id="pan12495-sec-0002" sec-type="section"> <title>Objectives</title> <p>The aim of the present meta‐analysis was to compare the perioperative respiratory complications between laryngeal mask airway and TI.</p> </sec> <sec id="pan12495-sec-0003" sec-type="section"> <title>Methods</title> <p>A meta‐analysis of available controlled studies comparing laryngeal mask airway to TI was conducted. Studies including patients with airway infection were excluded. Data from each trial were combined to calculate the pooled odds ratios (OR) or mean difference (MD) and 95% confidence intervals.</p> </sec> <sec id="pan12495-sec-0004" sec-type="section"> <title>Results</title> <p>The meta‐analysis was performed on 19 studies. In 12 studies, patients were given muscle relaxation, and in 16 studies, ventilation was controlled. During recovery from anesthesia, the incidence of desaturation (OR = 0.34 [0.19–0.62]), laryngospasm (OR = 0.34 [0.2–0.6]), cough (OR = 0.18 [0.11–0.27]), and breath holding (0.19 [0.05–0.68]) was lower when laryngeal mask airway was used to secure the airway. Postoperative incidences of sore throat (OR = 0.87 [0.53–1.44]), bronchospasm (OR = 0.56 [0.25–1.25]), aspiration (1.33 [0.46–3.91]) and blood staining on the device (OR = 0.62 [0.21–1.82]) did not differ between laryngeal mask airway and TI. Results were homogenous across the studies, with the exceptions of blood staining on the device.</p> </sec> <sec id="pan12495-sec-0005" sec-type="section"> <title>Conclusions</title> <p>This meta‐analysis found that the use of laryngeal mask airway in pediatric anesthesia results in a decrease in a number of common postanesthetic complications. It is therefore a valuable device for the management of the pediatric airway.</p> </sec> </abstract>