Comparison of the efficacy of supraglottic airway devices in low-risk adult patients: a network meta-analysis and systematic review

AbstractNumerous supraglottic airway device (SADs) have been designed for adults; however, their relative efficacy, indicated by parameters such as adequacy of sealing, ease of application, and postinsertion complications, remains unclear. We conducted a systematic review and network meta-analysis to evaluate the efficacy of various SADs. We searched electronic databases for randomized controlled trials comparing at least two types of SADs published before December 2019. The primary outcomes were oropharyngeal leak pressure (OLP), risk of first-attempt insertion failure, and postoperative sore throat rate (POST). We included 108 studies (n = 10,645) comparing 17 types of SAD. The Proseal laryngeal mask airway (LMA), the I-gel supraglottic airway, the Supreme LMA, the Streamlined Liner of the Pharynx Airway, the SoftSeal, the Cobra Perilaryngeal Airway, the Air-Q, the Laryngeal Tube, the Laryngeal Tube Suction II, the Laryngeal Tube Suction Disposable, AuraGain, and Protector had significantly higher OLP (mean difference ranging from 3.98 to 9.18 cmH2O) compared with that of a classic LMA (C-LMA). The Protector exhibited the highest OLP and was ranked first. All SADs had a similar likelihood of first-attempt insertion failure and POST compared with the C-LMA. Our findings indicate that the Protector may be the best SAD because it has the highest OLP.Systematic review registration PROSPERO: CRD42017065273.

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Comparative Efficacy of the Air-Q Intubating Laryngeal Airway during General Anesthesia in Pediatric Patients: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2016/6406391 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 5

Author(s):

Eun Jin Ahn ◽

Geun Joo Choi ◽

Hyun Kang ◽

Chong Wha Baek ◽

Yong Hun Jung ◽

...

Keyword(s):

Systematic Review ◽

General Anesthesia ◽

Pediatric Patients ◽

Meta Analysis ◽

Final Analysis ◽

Airway Device ◽

Supraglottic Airway ◽

Comparative Efficacy ◽

Supraglottic Airway Devices ◽

Airway Devices

Air-Q® (air-Q) is a supraglottic airway device which can be used as a guidance of intubation in pediatric as well as in adult patients. We evaluated the efficacy and safety of air-Q compared to other airway devices during general anesthesia in pediatric patients by conducting a systematic review and meta-analysis. A total of 10 studies including 789 patients were included in the final analysis. Compared with other supraglottic airway devices, air-Q showed no evidence for a difference in leakage pressure and insertion time. The ease of insertion was significantly lower than other supraglottic airway devices. The success rate of intubation was significantly lower than other airway devices. However, fiberoptic view was better through the air-Q than other supraglottic airway devices. Therefore, air-Q could be a safe substitute for other airway devices and may provide better fiberoptic bronchoscopic view.

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Standard versus Rotation Technique for Insertion of Supraglottic Airway Devices: Systematic Review and Meta-Analysis

Yonsei Medical Journal ◽

10.3349/ymj.2016.57.4.987 ◽

2016 ◽

Vol 57 (4) ◽

pp. 987 ◽

Cited By ~ 6

Author(s):

Jin Ha Park ◽

Jong Seok Lee ◽

Sang Beom Nam ◽

Jin Wu Ju ◽

Min-Soo Kim

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Supraglottic Airway ◽

Supraglottic Airway Devices ◽

Rotation Technique ◽

Airway Devices

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Influence of head and neck position on the performance of supraglottic airway devices: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0216673 ◽

2019 ◽

Vol 14 (5) ◽

pp. e0216673

Author(s):

Min-Soo Kim ◽

Jin Ha Park ◽

Ki-Young Lee ◽

Seung Ho Choi ◽

Hwan Ho Jung ◽

...

Keyword(s):

Systematic Review ◽

Head And Neck ◽

Meta Analysis ◽

Supraglottic Airway ◽

Neck Position ◽

Supraglottic Airway Devices ◽

Airway Devices ◽

Head And Neck Position

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Comparison of Five 2nd-Generation Supraglottic Airway Devices for Airway Management Performed by Novice Military Operators

BioMed Research International ◽

10.1155/2015/201898 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Tomas Henlin ◽

Michal Sotak ◽

Petr Kovaricek ◽

Tomas Tyll ◽

Lukas Balcarek ◽

...

Keyword(s):

Laryngeal Tube ◽

Insertion Time ◽

Supraglottic Airway ◽

Low Light ◽

2Nd Generation ◽

Supraglottic Airway Devices ◽

Military Background ◽

Blinded Study ◽

Tube Suction ◽

Airway Devices

Objectives. Five different second-generation supraglottic airway devices, ProSeal LMA, Supreme LMA, i-gel, SLIPA, and Laryngeal Tube Suction-D, were studied. Operators were inexperienced users with a military background, combat lifesavers, nurses, and physicians.Methods. This was a prospective, randomized, single-blinded study. Devices were inserted in the operating room in low light conditions after induction of general anesthesia. Primary outcome was successful insertion on the first attempt while secondary aims were insertion time, number of attempts, oropharyngeal seal pressure, ease of insertion, fibre optic position of device, efficacy of ventilation, and intraoperative trauma or regurgitation of gastric contents.Results. In total, 505 patients were studied. First-attempt insertion success rate was higher in the Supreme LMA (96%), i-gel (87.9%), and ProSeal LMA (85.9%) groups than in the Laryngeal Tube Suction-D (80.6%) and SLIPA (69.4%) groups. Insertion time was shortest in the Supreme LMA (70.4 ± 32.5 s) and i-gel (74.4 ± 41.1 s) groups (p<0.001). Oropharyngeal seal pressures were higher in the Laryngeal Tube Suction-D and ProSeal LMA groups than in other three devices.Conclusions. Most study parameters for the Supreme LMA and i-gel were found to be superior to the other three tested supraglottic airway devices when inserted by novice military operators.

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