Lee Juncheol, Cho Youngsuk, Kim Wonhee, Choi Kyu-Sun, Jang Bo-Hyoung, Shin Hyungoo, Ahn Chiwon, Kim Jae Guk, Na Min Kyun, Lim Tae Ho, Kim Dong Won
Department of Emergency Medicine, Hanyang University College of Medicine, Seoul 04763, Korea.
Department of Emergency Medicine, Hallym University, Kangdong Sacred Heart Hospital, Seoul 05355, Korea.
J Pers Med. 2022 Feb 26;12(3):363. doi: 10.3390/jpm12030363.
The efficacy and safety of videolaryngoscopes (VLs) for tracheal intubation is still conflicting and changeable according to airway circumstances. This study aimed to compare the efficacy and safety of several VLs in patients undergoing general anesthesia.
Medline, EMBASE, and the Cochrane Library were searched until 13 January 2020. The following VLs were evaluated compared to the Macintosh laryngoscope (MCL) by network meta-analysis for randomized controlled trials (RCTs): Airtraq, Airwayscope, C-MAC, C-MAC D-blade (CMD), GlideScope, King Vision, and McGrath. Outcome measures were the success and time (speed) of intubation, glottic view, and sore throat (safety).
A total of 9315 patients in 96 RCTs were included. The highest-ranked VLs for first-pass intubation success were CMD (90.6 % in all airway; 92.7% in difficult airway) and King Vision (92% in normal airway). In the rank analysis for secondary outcomes, the following VLs showed the highest efficacy or safety: Airtraq (safety), Airwayscope (speed and view), C-MAC (speed), CMD (safety), and McGrath (view). These VLs, except McGrath, were more effective or safer than MCL in moderate evidence level, whereas there was low certainty of evidence in the intercomparisons of VLs.
CMD and King Vision could be relatively successful than MCL and other VLs for tracheal intubation under general anesthesia. The comparisons of intubation success between VLs and MCL showed moderate certainty of evidence level, whereas the intercomparisons of VLs showed low certainty evidence.
视频喉镜（VLs）用于气管插管的有效性和安全性仍存在争议，且会因气道情况而变化。本研究旨在比较几种视频喉镜在全身麻醉患者中的有效性和安全性。
检索Medline、EMBASE和Cochrane图书馆直至2020年1月13日。通过网络荟萃分析对随机对照试验（RCTs）进行评估，将以下视频喉镜与麦金托什喉镜（MCL）进行比较：Airtraq、Airwayscope、C-MAC、C-MAC D型叶片（CMD）、GlideScope、King Vision和McGrath。观察指标包括插管的成功率和时间（速度）、声门视野以及咽痛（安全性）。
共纳入96项RCTs中的9315例患者。首次插管成功率最高的视频喉镜是CMD（所有气道中为90.6%；困难气道中为92.7%）和King Vision（正常气道中为92%）。在次要结局的排名分析中，以下视频喉镜显示出最高的有效性或安全性：Airtraq（安全性）、Airwayscope（速度和视野）、C-MAC（速度）、CMD（安全性）和McGrath（视野）。除McGrath外，这些视频喉镜在中等证据水平下比MCL更有效或更安全，而视频喉镜之间的相互比较证据确定性较低。
在全身麻醉下气管插管时，CMD和King Vision可能比MCL及其他视频喉镜相对更成功。视频喉镜与MCL之间插管成功率的比较显示证据水平的确定性为中等，而视频喉镜之间的相互比较显示证据确定性较低。
