Comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation: a meta-analysis of randomised trials

Eur J Anaesthesiol. 2011 Nov;28(11):788-95. doi: 10.1097/EJA.0b013e32834a34f3.

Abstract

Background: Video laryngoscopes have been introduced in recent years as an alternative choice to facilitate tracheal intubation. We conducted a meta-analysis to assess their value when compared with direct laryngoscopy.

Methods: PubMed and EMBASE were searched up until 24 September 2010. Randomised trials that reported data on the comparison of video laryngoscopes with direct laryngoscopy for tracheal intubation were included.

Results: Eleven trials with a total of 1196 participants were identified. During tracheal intubation, video laryngoscopes can achieve a better view of the glottis and have a similar success rate [rate ratio 1.0; 95% confidence interval (CI) 0.99-1.01]. Overall, the time to tracheal intubation was not different between the video laryngoscopes and direct laryngoscopy (standardised mean difference 0.19; 95% CI -0.37-0.75). However, in a subgroup analysis, video laryngoscopes shortened the time taken for difficult intubation (standardised mean difference, -0.75; 95% CI -1.24 to -0.25).

Conclusion: Video laryngoscopes are a good alternative to direct laryngoscopy during tracheal intubation. The advantage seems to be more prominent when difficult intubation is encountered.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Child
  • Child, Preschool
  • Equipment Design
  • Evidence-Based Medicine
  • Female
  • Glottis / anatomy & histology
  • Humans
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / instrumentation*
  • Intubation, Intratracheal / methods*
  • Laryngoscopes* / adverse effects
  • Laryngoscopy / adverse effects
  • Laryngoscopy / instrumentation*
  • Laryngoscopy / methods*
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic*
  • Time Factors
  • Video Recording*