Article Data

  • Views 498
  • Dowloads 161

Meta-Analyses

Open Access

Comparison of the incidence of postoperative sore throat between patients undergoing videolaryngoscope-guided versus Macintosh laryngoscope-guided double-lumen intubation: a systematic review and meta-analysis

  • Yayi Yu1
  • Ying Liu1
  • Wu Zhong1,2

1Department of Emergency Intensive Care Unit, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China

2The Luzhou People’s Hospital, 646000 Luzhou, Sichuan, China

DOI: 10.22514/sv.2022.008

Submitted: 21 October 2021 Accepted: 14 December 2021

Online publish date: 20 January 2022

*Corresponding Author(s): Wu Zhong E-mail: zhongwu_2876@sina.com

Abstract

Postoperative sore throat is a common complication of tracheal intubation, especially double-lumen tube intubation, after general anesthesia. Several studies have been conducted to compare the incidence of postoperative sore throat among patients un-dergoing videolaryngoscope-guided double-lumen intubation with that among patients undergoing Macintosh laryngoscope-guided double-lumen intubation. We purported to summarize all the existing evidences to explore the effect of videolaryngoscope and Macintosh laryngoscope on postoperative sore throat in patients with double-lumen intubation. PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure databases were searched for all randomized controlled trials published before 01 June 2021 that compared videolaryngoscopy with Macintosh laryngoscopy for prevention of postoperative sore throat among patients undergoing double-lumen intubation. The results showed that, 9 studies involving 695 patients were included in our meta-analysis. There was no significant difference about the incidence of postoperative hoarseness (risk ratio: 0.80; 95% confidence interval: 0.49–1.32; p-value = 0.38; I2 = 83%), tube malposition (risk ratio: 0.75; 95% confidence interval: 0.07–7.60; p-value = 0.80; I2 = 71%) and the success rate at the first attempt (risk ratio: 1.03; 95% confidence interval: 0.96–1.10; p-value = 0.42; I2 = 70%) between the two groups. We found that the videolaryngoscopy provided much lower incidence of oral injury (risk ratio: 0.49; 95% confidence interval: 0.27–0.89; p-value = 0.02; I2 = 7%) compared with Macintosh laryngoscopy. There was no significant difference in the incidence of postoperative sore throat (risk ratio: 0.74; 95% confidence interval: 0.42–1.32; p-value = 0.31; I2 = 87%) between the two groups. The sensitivity analysis excluding one study suggested that the incidence of postoperative sore throat was lower in the videolaryngoscopy group (risk ratio: 0.64; 95% confidence interval: 0.46–0.89; p-value = 0.008; I2 = 19%). The subgroup analysis suggested that the incidence of postoperative sore throat was lower in the videolaryngoscopy group in studies performed by experienced anesthetists (risk ratio: 0.62; 95% confidence interval: 0.45–0.87; p-value = 0.005; I2 = 5%). The current evidence demonstrates that, experienced anesthetist under the guidance of videolaryngoscope can significantly reduce the risk of postoperative sore throat in patients with double-lumen intubation. Using the videolaryngoscope resulted in a lower incidence of oral injury-related complications. However, there was no advantage in using a videolaryngoscope over Macintosh laryngoscope in the reduction of postoperative hoarseness, tube malposition and the success rate at first attempt.


Keywords

Videolaryngoscope; Macintosh laryngoscope; Tracheal intubation; Double-lumen tube; Postoperative sore throat


Cite and Share

Yayi Yu,Ying Liu,Wu Zhong. Comparison of the incidence of postoperative sore throat between patients undergoing videolaryngoscope-guided versus Macintosh laryngoscope-guided double-lumen intubation: a systematic review and meta-analysis. Signa Vitae. 2022.doi:10.22514/sv.2022.008.

References

[1] McHardy FE, Chung F. Postoperative sore throat: cause, prevention and treatment. Anaesthesia. 1999; 54: 444–453.

[2] Huybrechts I, Tuna T, Szegedi LL. Lung separation in adult thoracic anesthesia. Saudi Journal of Anaesthesia. 2021; 15: 272–279.

[3] Campos JH. Which device should be considered the best for lung isolation: double-lumen endotracheal tube versus bronchial blockers. Current Opinion in Anaesthesiology. 2007; 20: 27–31.

[4] McIntosh CA, Macario A. Managing quality in an anesthesia department. Current Opinion in Anaesthesiology. 2009; 22: 223–231.

[5] Chandler M. Tracheal intubation and sore throat: a mechanical explanation. Anaesthesia. 2002; 57: 155–161.

[6] Loeser EA, Bennett GM, Orr DL, Stanley TH. Reduction of postoperative sore throat with new endotracheal tube cuffs. Anesthesiology. 1980; 52: 257–259.

[7] Lehmann M, Monte K, Barach P, Kindler CH. Postoperative patient complaints: a prospective interview study of 12,276 patients. Journal of Clinical Anesthesia. 2010; 22: 13–21.

[8] Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesthesia & Analgesia. 1999; 89: 652–658.

[9] Inoue S, Abe R, Tanaka Y, Kawaguchi M. Tracheal intubation by trainees does not alter the incidence or duration of postoperative sore throat and hoarseness: a teaching hospital-based propensity score analysis. British Journal of Anaesthesia. 2015; 115: 463–469.

[10] Kalil DM, Silvestro LS, Austin PN. Novel preoperative pharmacologic methods of preventing postoperative sore throat due to tracheal intuba-tion. AANA Journal. 2014; 82: 188–197.

[11] Hsu HT, Chou SH, Wu PJ, Tseng KY, Kuo YW, Chou CY, et al. Comparison of the GlideScope® videolaryngoscope and the Macintosh laryngoscope for double-lumen tube intubation. Anaesthesia. 2012; 67: 411–415.

[12] Bakshi SG, Gawri A, Divatia JV. McGrath MAC video laryngoscope versus direct laryngoscopy for the placement of double-lumen tubes: a randomised control trial. Indian Journal of Anaesthesia. 2019; 63: 456–461.

[13] Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009; 339: b2535.

[14] Wasem S, Lazarus M, Hain J, Festl J, Kranke P, Roewer N, et al. Comparison of the Airtraq and the Macintosh laryngoscope for double-lumen tube intubation: a randomised clinical trial. European Journal of Anaesthesiology. 2013; 30: 180–186.

[15] Russell T, Slinger P, Roscoe A, McRae K, Van Rensburg A. A randomised controlled trial comparing the GlideScope® and the Macintosh laryngo-scope for double-lumen endobronchial intubation. Anaesthesia. 2013; 68: 1253–1258.

[16] Kido H, Komasawa N, Matsunami S, Kusaka Y, Minami T. Comparison of McGRATH MAC and Macintosh laryngoscopes for double-lumen endotracheal tube intubation by anesthesia residents: a prospective randomized clinical trial. Journal of Clinical Anesthesia. 2015; 27: 476–480.

[17] Lin W, Li H, Liu W, Cao L, Tan H, Zhong Z. A randomised trial comparing the CEL-100 videolaryngoscopeTM with the Macintosh laryngoscope blade for insertion of double-lumen tubes. Anaesthesia. 2012; 67: 771–776.

[18] Hsu HT, Chou SH, Chen CL, Tseng KY, Kuo YW, Chen MK, et al. Left endobronchial intubation with a double-lumen tube using direct laryngoscopy or the Trachway® video stylet. Anaesthesia. 2013; 68: 851–855.

[19] Xu T, Li M, Guo XY. Comparison of Shikani optical stylet and Macintosh laryngoscope for double-lumen endotracheal tube intubation. Journal of Peking University (Health Sciences). 2015; 47: 853–857. (In Chinese)

[20] Yao WL, Wan L, Xu H, Qian W, Wang XR, Tian YK, et al. A comparison of the McGrath® Series 5 videolaryngoscope and Macintosh laryngoscope for double-lumen tracheal tube placement in patients with a good glottic view at direct laryngoscopy. Anaesthesia. 2015; 70: 810–817.

[21] Su YC, Chen CC, Lee YK, Lee JY, Lin KJ. Comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation: a meta-analysis of randomised trials. European Journal of Anaesthesiology. 2011; 28: 788–795.

[22] Savino PB, Reichelderfer S, Mercer MP, Wang RC, Sporer KA. Direct versus video laryngoscopy for prehospital intubation: a systematic review and meta-analysis. Academic Emergency Medicine. 2017; 24: 1018–1026.

[23] Sun Y, Lu Y, Huang Y, Jiang H. Pediatric video laryngoscope versus direct laryngoscope: a meta-analysis of randomized controlled trials. Pediatric Anesthesia. 2014; 24: 1056–1065.

[24] Suppan L, Tramèr MR, Niquille M, Grosgurin O, Marti C. Alternative intubation techniques vs. Macintosh laryngoscopy in patients with cervical spine immobilization: systematic review and meta-analysis of randomized controlled trials. British Journal of Anaesthesia. 2016; 116: 27–36.

[25] Berning V, Laupheimer M, Nübling M, Heidegger T. Influence of quality of recovery on patient satisfaction with anaesthesia and surgery: a prospective observational cohort study. Anaesthesia. 2017; 72: 1088–1096.

[26] Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. British Journal of Anaesthesia. 2015; 115: 827–848.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 0.5(2021) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top