Skip to main content
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 5/2022

23.02.2022 | Reports of Original Investigations

Airtraq® versus GlideScope® for tracheal intubation in adults: a systematic review and meta-analysis with trial sequential analysis

verfasst von: Hiroshi Hoshijima, DDS, PhD, Takahiro Mihara, MD, PhD, Yohei Denawa, MD, Toshiya Shiga, MD, PhD, Kentaro Mizuta, DDS, PhD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 5/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

In recent years, various types of indirect laryngoscopes have been developed. Nevertheless, no conclusions have been drawn about which type of indirect laryngoscope is most effective for tracheal intubation. We performed a systematic review and meta-analysis to determine whether the Airtraq® or the GlideScope® is more effective for tracheal intubation.

Methods

We extracted studies of adult prospective randomized trials comparing tracheal intubation between the Airtraq and GlideScope. An electronic database was used to extract the studies included in our meta-analysis. We extracted the following data from the identified studies: success rate, glottic visualization, and intubation time. Data from each trial were combined via a random-effects model for calculation of pooled relative risk (RR) or weighted mean difference (WMD) with a 95% confidence interval (CI). We also performed trial sequential analysis.

Results

We included eight trials comprising 571 patients for review. Compared with the GlideScope, Airtraq did not improve success rate, glottic visualization, or intubation time in tracheal intubation (success rate: RR, 0.98; 95% CI, 0.91 to 1.05; P = 0.58; I2 = 65%; glottic visualization: RR, 1.07; 95% CI, 0.88 to 1.29; P = 0.69; I2 = 64%; and intubation time: WMD, 1.4 seconds ; 95% CI, -6.2 to 9.1; P = 0.72; I2 = 96%). The quality of evidence was graded as “very low.” Trial sequential analysis showed that total sample size did not reach the required information size for all parameters.

Conclusion

In this meta-analysis, use of the Airtraq indirect laryngoscope did not result in improved success rate, glottic visualization, or intubation time in tracheal intubation compared with the GlideScope. Trial sequential analysis suggests that further studies are necessary to confirm these findings.
Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
Available from URL: http://​www.​ctu.​dk/​tsa (accessed December 15, 2021)
 
Literatur
1.
Zurück zum Zitat Arslan ZI, Alparslan V, Ozdal P, Toker K, Solak M. Face-to-face tracheal intubation in adult patients: a comparison of the Airtraq™, Glidescope™ and Fastrach™ devices. J Anesth 2015; 29: 893-8.CrossRef Arslan ZI, Alparslan V, Ozdal P, Toker K, Solak M. Face-to-face tracheal intubation in adult patients: a comparison of the Airtraq™, Glidescope™ and Fastrach™ devices. J Anesth 2015; 29: 893-8.CrossRef
2.
Zurück zum Zitat Putz L, Dangelser G, Constant B, et al. Prospective trial comparing Airtraq and Glidescope techniques for intubation of obese patients (French). Ann Fr Anesth Reanim 2012; 31: 421-6.CrossRef Putz L, Dangelser G, Constant B, et al. Prospective trial comparing Airtraq and Glidescope techniques for intubation of obese patients (French). Ann Fr Anesth Reanim 2012; 31: 421-6.CrossRef
3.
Zurück zum Zitat Lange M, Frommer M, Redel A, et al. Comparison of the Glidescope and Airtraq optical laryngoscopes in patients undergoing direct microlaryngoscopy. Anaesthesia 2009; 64: 323-8.CrossRef Lange M, Frommer M, Redel A, et al. Comparison of the Glidescope and Airtraq optical laryngoscopes in patients undergoing direct microlaryngoscopy. Anaesthesia 2009; 64: 323-8.CrossRef
4.
Zurück zum Zitat Al-Ghamdi AA, El Tahan MR, Khidr AM. Comparison of the Macintosh, GlideScope®, Airtraq®, and King Vision™ laryngoscopes in routine airway management. Minerva Anestesiol 2016; 82: 1278-87.PubMed Al-Ghamdi AA, El Tahan MR, Khidr AM. Comparison of the Macintosh, GlideScope®, Airtraq®, and King Vision™ laryngoscopes in routine airway management. Minerva Anestesiol 2016; 82: 1278-87.PubMed
5.
Zurück zum Zitat Abdelgalel EF, Mowafy SM. Comparison between Glidescope, Airtraq and Macintosh laryngoscopy for emergency endotracheal intubation in intensive care unit: randomized controlled trial. Egypt J Anaesth 2018; 34: 123-8.CrossRef Abdelgalel EF, Mowafy SM. Comparison between Glidescope, Airtraq and Macintosh laryngoscopy for emergency endotracheal intubation in intensive care unit: randomized controlled trial. Egypt J Anaesth 2018; 34: 123-8.CrossRef
6.
Zurück zum Zitat Puchner W, Drabauer L, Kern K, et al. Indirect versus direct laryngoscopy for routine nasotracheal intubation. J Clin Anesth 2011; 23: 280-5.CrossRef Puchner W, Drabauer L, Kern K, et al. Indirect versus direct laryngoscopy for routine nasotracheal intubation. J Clin Anesth 2011; 23: 280-5.CrossRef
7.
Zurück zum Zitat Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med 2009; 3: e123-30. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med 2009; 3: e123-30.
10.
Zurück zum Zitat Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-60.CrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-60.CrossRef
12.
Zurück zum Zitat Wetterslev J, Thorlund K, Brok J, Gluud C. Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis. J Clin Epidemiol 2008; 61: 64-75.CrossRef Wetterslev J, Thorlund K, Brok J, Gluud C. Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis. J Clin Epidemiol 2008; 61: 64-75.CrossRef
14.
Zurück zum Zitat Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-34.CrossRef Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-34.CrossRef
15.
Zurück zum Zitat Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50: 1088-101.CrossRef Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994; 50: 1088-101.CrossRef
16.
Zurück zum Zitat Arab SA, Al Harbi MK, Al Basha A, et al. The efficacy and safety of three different types of videolaryngoscopes in adult patients with normal airways: a prospective randomized controlled trial. Middle East J Anesthesiol 2020; 27: 60-70. Arab SA, Al Harbi MK, Al Basha A, et al. The efficacy and safety of three different types of videolaryngoscopes in adult patients with normal airways: a prospective randomized controlled trial. Middle East J Anesthesiol 2020; 27: 60-70.
17.
Zurück zum Zitat Staar S, Biesler I, Muller D, Pfortner R, Mohr C, Groeben H. Nasotracheal intubation with three indirect laryngoscopes assisted by standard or modified Magill forceps. Anaesthesia 2013; 68: 467-71.CrossRef Staar S, Biesler I, Muller D, Pfortner R, Mohr C, Groeben H. Nasotracheal intubation with three indirect laryngoscopes assisted by standard or modified Magill forceps. Anaesthesia 2013; 68: 467-71.CrossRef
18.
Zurück zum Zitat Hoshijima H, Mihara T, Denawa Y, et al. Airtraq® is superior to the Macintosh laryngoscope for tracheal intubation: systematic review with trial sequential analysis. Am J Emerg Med 2019; 37: 1367-8.PubMed Hoshijima H, Mihara T, Denawa Y, et al. Airtraq® is superior to the Macintosh laryngoscope for tracheal intubation: systematic review with trial sequential analysis. Am J Emerg Med 2019; 37: 1367-8.PubMed
19.
Zurück zum Zitat Griesdale DE, Liu D, McKinney J, Choi PT. Glidescope® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis. Can J Anesth 2012; 59: 41-52.CrossRef Griesdale DE, Liu D, McKinney J, Choi PT. Glidescope® video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis. Can J Anesth 2012; 59: 41-52.CrossRef
20.
Zurück zum Zitat St Mont G, Biesler I, Pfortner R, Mohr C, Groeben H. Easy and difficult nasal intubation--a randomised comparison of Macintosh vs Airtraq® laryngoscopes. Anaesthesia 2012; 67: 132-8.CrossRef St Mont G, Biesler I, Pfortner R, Mohr C, Groeben H. Easy and difficult nasal intubation--a randomised comparison of Macintosh vs Airtraq® laryngoscopes. Anaesthesia 2012; 67: 132-8.CrossRef
21.
Zurück zum Zitat Ndoko SK, Amathieu R, Tual L, et al. Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes. Br J Anaesth 2008; 100: 263-8.CrossRef Ndoko SK, Amathieu R, Tual L, et al. Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes. Br J Anaesth 2008; 100: 263-8.CrossRef
22.
Zurück zum Zitat Sun DA, Warriner CB, Parsons DG, Klein R, Umedaly HS, Moult M. The GlideScope video laryngoscope: randomized clinical trial in 200 patients. Br J Anaesth 2005; 94: 381-4.CrossRef Sun DA, Warriner CB, Parsons DG, Klein R, Umedaly HS, Moult M. The GlideScope video laryngoscope: randomized clinical trial in 200 patients. Br J Anaesth 2005; 94: 381-4.CrossRef
23.
Zurück zum Zitat Malik MA, Subramaniam R, Maharaj CH, Harte BH, Laffey JG. Randomized controlled trial of the Pentax AWS, Glidescope, and Macintosh laryngoscopes in predicted difficult intubation. Br J Anaesth 2009; 103: 761-8.CrossRef Malik MA, Subramaniam R, Maharaj CH, Harte BH, Laffey JG. Randomized controlled trial of the Pentax AWS, Glidescope, and Macintosh laryngoscopes in predicted difficult intubation. Br J Anaesth 2009; 103: 761-8.CrossRef
24.
Zurück zum Zitat Dhonneur G, Ndoko SK, Amathieu R, et al. A comparison of two techniques for inserting the Airtraq laryngoscope in morbidly obese patients. Anaesthesia 2007; 62: 774-7.CrossRef Dhonneur G, Ndoko SK, Amathieu R, et al. A comparison of two techniques for inserting the Airtraq laryngoscope in morbidly obese patients. Anaesthesia 2007; 62: 774-7.CrossRef
25.
Zurück zum Zitat Hirabayashi Y, Otsuka Y. Apparent blind spot with the GlideScope video laryngoscope. Br J Anaesth 2009; 103: 461-2.CrossRef Hirabayashi Y, Otsuka Y. Apparent blind spot with the GlideScope video laryngoscope. Br J Anaesth 2009; 103: 461-2.CrossRef
26.
Zurück zum Zitat van Zundert A, Pieters B, van Zundert T, Gatt S. Avoiding palatopharyngeal trauma during videolaryngoscopy: do not forget the 'blind spots'. Acta Anaesthesiol Scand 2012; 56: 532-4.CrossRef van Zundert A, Pieters B, van Zundert T, Gatt S. Avoiding palatopharyngeal trauma during videolaryngoscopy: do not forget the 'blind spots'. Acta Anaesthesiol Scand 2012; 56: 532-4.CrossRef
Metadaten
Titel
Airtraq® versus GlideScope® for tracheal intubation in adults: a systematic review and meta-analysis with trial sequential analysis
verfasst von
Hiroshi Hoshijima, DDS, PhD
Takahiro Mihara, MD, PhD
Yohei Denawa, MD
Toshiya Shiga, MD, PhD
Kentaro Mizuta, DDS, PhD
Publikationsdatum
23.02.2022
Verlag
Springer International Publishing
Erschienen in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 5/2022
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-022-02217-0

Weitere Artikel der Ausgabe 5/2022

Canadian Journal of Anesthesia/Journal canadien d'anesthésie 5/2022 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.