Laryngeal Masks Versus Tracheal Intubation In Difficult Airway: A Meta-analysis Of Randomized Controlled Trials

Objective: We reviewed the updated literature and performed a meta-analysis based on randomized controlled trials in difficult airway to compare the clinical efficacy between Laryngeal Masks(LMAs)and Tracheal Intubation(TI).Methods: We searched articles published the key words‘ difficult airway,difficult intubation,difficult laryngoscopy,Intubation,Intratracheal,Laryngeal Masks,Randomized Controlled Trial,Controlled Clinical Trial,Randomized Controlled Trials as Topic’ in PubMed、Cochrane Library、Google Scholar、CNKI、WanFang Data.Only prospective randomized controlled trials(RCTs),which compared the use of LMAs and Tracheal Tube(TTs)in difficult airway,were included.The relative risk(RR),weighted mean difference(WMD),and their corresponding 95% confidence interval(95% CI)were calculated using the quality effects model of the RevMan5.3 software for outcome data.Results: The Meta analysis included 13 studies.Subgroup analysis showed the ILMAs and TTs(CI:0.84-1.10,P=0.59)were similar in the success rate of the first attempt,while the standard LMAs(CI:1.21-1.59,P<0.05)and the second-generaton LMAs(P<0.05)were higher.The time to intubation(TTI)in ILMAs was prolonged in comparison to TTs,the other subgroups were similar to TTs.Although the incidence of failure were similar in both groups,the incidence of associated complications are lower in the LMAs group.Conclusion: LMAs and TTs are effective means to deal with difficult airway.When Laryngeal masks used in the appropriate situation,there are fewer adverse events occurred than TTs.However,further studies are needed to clarify the efficacy and safety of the different methods in endotracheal because it is still an important and irreplaceable way for difficult airway.