Videolaryngoscopy versus direct laryngoscopy for nasotracheal intubation: A systematic review and meta-analysis of randomised controlled trials

Jiang, Jia; Ma, Dong; Li, Bo; Wu, Anshi; Xue, Fu‐Shan

doi:10.1016/j.jclinane.2018.08.029

Cited by 24 publications

(21 citation statements)

References 42 publications

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“…[7][8][9]12,14,17,18,20,[22][23][24][25][26]28,29,32 Heterogeneity in clinical experience was found in most meta-analyses (20/ 21; 95%). [7][8][9][10]14,[16][17][18]20,[22][23][24][25][26][28][29][30][32][33][34] Heterogeneity of practitioner specialty (prehospital, emergency, intensive care, or anesthesia) occurred in 15 of the 21 (71%) metaanalyses. [7][8][9][10]14,[16][17][18][22][23][24][25][26]28,34 Heterogeneity across locations (e.g., pr...…”

Section: Resultsmentioning

confidence: 99%

A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngoscopy

Downey

Duggan

Law

2021

Can J Anesth/J Can Anesth

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In the preceding 20 years, many randomizedcontrolled trials and meta-analyses have compared direct Macintosh laryngoscopy with videolaryngoscopy. The videolaryngoscope blades have included both traditional Macintosh blades and hyperangulated blades. Macintosh and hyperangulated blades differ in their geometry and technique for tracheal intubation; certain patient populations may benefit from one blade type over another. The primary objective of this systematic review was to assess whether published meta-analyses comparing direct Macintosh laryngoscopy to videolaryngoscopy have accounted for the videolaryngoscope blade type. Secondary objectives evaluated heterogeneity among practitioner experience and specialty, clinical context, patient population, and original primary study outcomes. Source A search was performed across Ovid Medline, Ovid Embase, ClinicalKey, PubMed, TRIP, AccessAnesthesiology, Google Scholar, and ANZCA discovery. A systematic review identified meta-analyses which compared direct Macintosh laryngoscopy to videolaryngoscopy. There were no patient age or clinical specialty restrictions. Exclusion criteria included non-

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Section: Resultsmentioning

confidence: 99%

A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngoscopy

Downey

Duggan

Law

2021

Can J Anesth/J Can Anesth

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“…A recent systematic review comparing VL versus DL for NTI showed that VL is particularly beneficial for patients with difficult airways [16]. However, only two randomized controlled trials (Airtriq and C-MAC versus Macintosh) were enrolled [7, 17].…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled comparison of non-channeled king vision, McGrath MAC video laryngoscope and Macintosh direct laryngoscope for nasotracheal intubation in patients with predicted difficult intubations

et al. 2019

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Background King Vision and McGrath MAC video laryngoscopes (VLs) are increasingly used. The purpose of this study was to evaluate the performance of nasotracheal intubation in patients with predicted difficult intubations using non-channeled King Vision VL, McGrath MAC VL or Macintosh laryngoscope by experienced intubators. Methods Ninety nine ASA I or II adult patients, scheduled for oral maxillofacial surgeries with El-Ganzouri risk index 1–7 were enrolled. Patients were randomly allocated to intubate with one of three laryngoscopes (non-channeled King Vision, McGrath MAC and Macintosh). The intubators were experienced with more than 100 successful nasotracheal intubations using each device. The primary outcome was intubation time. The secondary outcomes included first success rate, time required for viewing the glottis, Cormack-Lehane grade of glottis view, the number of assist maneuvers, hemodynamic responses, the subjective evaluating of sensations of performances and associated complications. Results The intubation time of King Vision and McGrath group was comparable (37.6 ± 7.3 s vs. 35.4 ± 8.8 s) and both were shorter than Macintosh group (46.8 ± 10.4 s, p < 0.001). Both King Vision and McGrath groups had a 100% first attempt success rate, significantly higher than Macintosh group (85%, p < 0.05). The laryngoscopy time was comparable between King Vision and McGrath group (16.7 ± 5.5 s vs. 15.6 ± 6.3 s) and was shorter than Macintosh group (22.8 ± 7.2 s, p < 0.05) also. Compared with Macintosh laryngoscope, Glottis view was obviously improved when exposed with either non-channeled King Vision or McGrath MAC VL ( p < 0.001), and assist maneuvers required were reduced ( p < 0.001). The maximum fluctuations of MAP were significantly attenuated in VL groups (47.7 ± 12.5 mmHg and 45.1 ± 10.3 mmHg vs. 54.9 ± 10.2 mmHg, p < 0.05 and p < 0.01). Most device insertions were graded as excellent in McGrath group, followed by Macintosh and King Vision group ( p = 0.0014). The tube advancements were easier in VLs compared with the Macintosh laryngoscope ( p < 0.001). Sore throat was found more frequent in Macintosh group compared with King Vision group ( p < 0.05). Conclusions Non-channeled King Vision and McGrath MAC VLs were comparable and both devices facilitated nasotracheal intubation in managing predicted difficult intubations compared with Macintosh laryngoscope. Trial registration ClinicalTrials registration number NCT03126344 . Registered on April 24, 2017. Electronic supplementary material The online version of this article (10.1186/s12871-019-0838-z) contains ...

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“…Therefore, our results cannot extrapolate to patients with expected difficult airways. Recent meta-analysis has shown that video laryngoscope is particularly beneficial for patients with difficult airways [25]. Therefore, it may be applied to patients with difficult airways or to other type of video laryngoscope.…”

Section: Discussionmentioning

confidence: 99%

Neutral Position Facilitates Nasotracheal Intubation with a GlideScope Video Laryngoscope: A Randomized Controlled Trial

Kang

Jeong

et al. 2020

JCM

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The optimal head position for GlideScope facilitated nasotracheal intubation has not yet been determined. We compared the neutral and sniffing positions to establish the degree of intubation difficulty. A total of 88 ASA I-II patients requiring nasotracheal intubation for elective dental surgery with normal airways were divided into two groups according to head position, neutral position (group N), and sniffing position (group S). The primary outcome was the degree of intubation difficulty according to the Intubation Difficulty Scale (IDS): Easy (IDS = 0), mildly difficult (IDS = 1 to 4), and moderately to severely difficult (IDS ≥ 5). Eighty-seven patients completed the study and their data were analyzed. The degree of intubation difficulty was significantly different between the two groups (p = 0.004). The frequency of difficult intubation (IDS > 0) was 12 (27.9%) in group N and 28 (63.6%) in group S (difference in proportion, 35.7%; 95% confidence interval [CI], 14.8 to 52.6%; p = 0.001). The neutral position facilitates nasotracheal intubation with GlideScope by aligning the nasotracheal tube and the glottis inlet more accurately than the sniffing position.

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Videolaryngoscopy versus direct laryngoscopy for nasotracheal intubation: A systematic review and meta-analysis of randomised controlled trials

Cited by 24 publications

References 42 publications

A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngoscopy

A systematic review of meta-analyses comparing direct laryngoscopy with videolaryngoscopy

A randomized controlled comparison of non-channeled king vision, McGrath MAC video laryngoscope and Macintosh direct laryngoscope for nasotracheal intubation in patients with predicted difficult intubations

Neutral Position Facilitates Nasotracheal Intubation with a GlideScope Video Laryngoscope: A Randomized Controlled Trial

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