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

摘要

Study objectiveNasotracheal intubation (NTI) is a common practice in the oral and maxillofacial surgeries. A systematic review and meta-analysis was performed to determine whether videolaryngoscopy (VL) compared with direct laryngoscopy (DL) can lead to better outcomes for NTI in adult surgical patients. MeasurementsOnly randomised controlled trials comparing VL and DL for NTI were included. The primary outcome was overall success rate and the second outcomes were first-attempt success rate, intubation time, rate of Cormack and Lehane classification 1, rate of Magill Forceps used, rate of postoperative sore throat, and ease of intubation. Main resultsFourteen studies with 20 comparisons (n?=?1052) were included in quantitative synthesis. The overall success rate was similar between two groups (RR, 1.03;p?=?0.14; moderate-quality evidence). VL was associated with a higher first-attempt success rate (RR 1.09;p?=?0.04; low-quality evidence), a shorten intubation time (MD-6.72?s;p?=?0.0001; low-quality evidence), a higher rate of Cormack and Lehane classification 1 (RR, 2.11;p? ?0.05); Subgroup analysis based on operators' experience showed that success rate did not differ between groups (p?>?0.05), but intubation time was shortened by more than 50s by non-experienced operators (p?