Zheng Zhihao, Li Haibo, Dai Congcong, Bi Liwei, Sun Wei, Yu Miao, Hu Zhanfei, Liang Xiaodong
Department of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, Inner Mongolia, China.
Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, Inner Mongolia, China.
Anesthesiol Res Pract. 2025 Mar 18;2025:1224567. doi: 10.1155/anrp/1224567. eCollection 2025.
The insertion of a laryngeal mask airway (LMA) using a laryngoscope-guided technique has produced inconsistent outcomes. The use of laryngoscope guidance in facilitating LMA insertion needs further investigation. This meta-analysis compared its effectiveness and safety against standard blind insertion. We systematically searched PubMed, Cochrane Library, Web of Science, and Ovid Medline for randomized controlled trials comparing laryngoscope-guided (Group L) and blind LMA insertion (Group B). The primary outcome measured was fiberoptic staging. The secondary outcomes included oropharyngeal leak pressure (OLP), insertion time, success rate on the first attempt, and the incidence of postoperative sore throat and blood staining. Nine RCTs (1016 patients) were analyzed. The fiberoptic staging in Group L was found to be significantly higher than that in Group B (RR = 1.54; 95% CI: 1.14-2.08; =0.005). In addition, the OLP of Group L is significantly higher than that of Group B (MD = 2.10 cmHO; 95% CI: 0.38 cmHO-3.83 cmHO; =0.02). The success rate for the first attempt was also higher in Group L (RR = 1.14; 95% CI: 1.06-1.22; =0.0005). The insertion time (MD = 3.92 s; 95% CI: -6.69 s-14.52 s; =0.47), the incidence of sore throat (RR = 0.90; 95% CI: 0.50-1.65; =0.74), and the incidence of blood staining (RR = 1.19; 95% CI: 0.29-4.79; =0.81) did not demonstrate statistically significant differences. The use of LMA with laryngoscope guidance may improve fiberoptic staging and OLP and increase the success rate of first-attempt insertion, without significantly raising the incidence of sore throat or blood staining in anesthetized patients.
使用喉镜引导技术插入喉罩气道（LMA）的效果并不一致。在促进LMA插入过程中使用喉镜引导仍需进一步研究。本荟萃分析比较了其与标准盲目插入相比的有效性和安全性。我们系统检索了PubMed、Cochrane图书馆、Web of Science和Ovid Medline，以查找比较喉镜引导下（L组）和盲目插入LMA（B组）的随机对照试验。测量的主要结果是纤维光学分级。次要结果包括口咽漏气压（OLP）、插入时间、首次尝试成功率以及术后咽痛和血染的发生率。分析了9项随机对照试验（1016例患者）。发现L组的纤维光学分级显著高于B组（RR = 1.54；95% CI：1.14 - 2.08；P = 0.005）。此外，L组的OLP显著高于B组（MD = 2.10 cmH₂O；95% CI：0.38 cmH₂O - 3.83 cmH₂O；P = 0.02）。L组首次尝试的成功率也更高（RR = 1.14；95% CI：1.06 - 1.22；P = 0.0005）。插入时间（MD = 3.92 s；95% CI： - 6.69 s - 14.52 s；P = 0.47）、咽痛发生率（RR = 0.90；95% CI：0.50 - 1.65；P = 0.74）和血染发生率（RR = 1.19；95% CI：0.29 - 4.79；P = 0.81）未显示出统计学上的显著差异。在喉镜引导下使用LMA可能会改善纤维光学分级和OLP，并提高首次尝试插入的成功率，而不会显著增加麻醉患者咽痛或血染的发生率。
