The impact of laryngeal mask versus other airways on perioperative respiratory adverse events in children: A systematic review and meta-analysis of randomized controlled trials
Background: Increasing studies have shown that the use of laryngeal mask airways (LMAs) improved the perioperative respiratory adverse events (PRAEs) in children. However, the results of some of these studies still remained controversial as their sample sizes were small. A systematic review and meta-analysis was designed to evaluate the impact of LMAs in decreasing PRAEs in children. Methods: We searched the Cochrane Library, PubMed, EMBASE and Web of Science up to May 29, 2018 to identify relevant randomized controlled trials (RCTs) which analyzed and evaluated the impact of LMAs in decreasing PRAEs in children. Participants were randomly assigned to receive LMAs (the intervention group) or other airways (the control group). We studied PRAEs which included breath apnea, laryngospasm, desaturation, cough, fever, pulmonary rales and pulmonary infection. Risk ratio (RR) with 95% confidence intervals (CIs) were estimated to compare the outcomes of the groups. We also performed subgroup analysis and sensitivity analysis to evaluate the impact of LMAs on further decreasing PRAEs. Two reviewers assessed the trial quality and extracted the data independently. All statistical analyses were performed using the standard statistical procedures provided in the Review Manager 5.2. Results: Twelve RCTs (N = 1577 participants) were identified. Comparing with other airways, significant reduction were found in the overall PRAEs (RR 0.52, 95% CI 0.39-0.70; P < 0.0001), major PRAEs (RR 0.47, 95% CI 0.29-0.79; P = 0.004) as well as minor PRAEs (RR 0.57, 95% CI 0.45-0.74; P < 0.0001) in patients managed with LMAs. When compared with endotracheal tubes (ETTs), LMAs also significantly reduced PRAEs. Further analysis also found that LMAs reduced the incidences of postoperative cough (RR 0.44, 95% CI 0.31-0.63; P < 0.00001), pulmonary rales (RR 0.62, 95% CI 0.44-0.87; P = 0.006) and infections (RR 0.28, 95% CI 0.13-0.61; P = 0.001) in children. Conclusions: LMAs reduced the incidences of many PRAEs in children and should be used as one of anaesthesia methods for children.
基金:
Baoding science and technology planning project [18ZF069]
第一作者机构:[1]Hebei Univ, Anesthesiol Dept, Affiliated Hosp, 212 Huayu East Rd, Baoding 071000, Hebei, Peoples R China
通讯作者:
通讯机构:[1]Hebei Univ, Anesthesiol Dept, Affiliated Hosp, 212 Huayu East Rd, Baoding 071000, Hebei, Peoples R China[*1]Anesthesiology Department, Affiliated Hospital of Hebei University, No. 212, Huayu East Road, Baoding, 071000, Hebei Province, China
推荐引用方式(GB/T 7714):
Li Lingzhi,Zhang Zhimin,Yao Zihan,et al.The impact of laryngeal mask versus other airways on perioperative respiratory adverse events in children: A systematic review and meta-analysis of randomized controlled trials[J].INTERNATIONAL JOURNAL OF SURGERY.2019,64:40-48.doi:10.1016/j.ijsu.2019.02.020.
APA:
Li, Lingzhi,Zhang, Zhimin,Yao, Zihan,Wang, Hongjie,Wang, Hebin...&Yao, Jun.(2019).The impact of laryngeal mask versus other airways on perioperative respiratory adverse events in children: A systematic review and meta-analysis of randomized controlled trials.INTERNATIONAL JOURNAL OF SURGERY,64,
MLA:
Li, Lingzhi,et al."The impact of laryngeal mask versus other airways on perioperative respiratory adverse events in children: A systematic review and meta-analysis of randomized controlled trials".INTERNATIONAL JOURNAL OF SURGERY 64.(2019):40-48