Evidence map›Paper›PMID 38899617›Full record

SynthesisJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale

The Safety of the Laryngeal Mask Airway in Adenotonsillectomy: A Systematic Review and Meta-Analysis.

Sami Khoury, Dorsa Zabihi-Pour, Jacob Davidson, Raju Poolacherla, Gopakumar Nair, Abhijit Biswas, Peng You, Julie E Strychowsky

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Review
  5. Alterations of Gut Microbiome Composition and Function Pre- and Post-Adenotonsillectomy in Children with Obstructive Sleep Apnea.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
    Observational
  6. Pediatric Adenoidectomy With Laryngeal Mask Airway in the Minor Procedure Room: A Quality Improvement Project.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sami KhouryDepartment of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.ORCID 0000-0002-7174-116X
Dorsa Zabihi-PourDepartment of Otolaryngology-Head and Neck Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Jacob DavidsonDivision of Pediatric Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Raju PoolacherlaDepartment of Anesthesia and Perioperative Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Gopakumar NairDepartment of Anesthesia and Perioperative Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Abhijit BiswasDepartment of Anesthesia and Perioperative Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Peng YouDepartment of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.ORCID 0000-0001-6573-5735
Julie E StrychowskyDepartment of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.ORCID 0000-0001-5460-3155

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdenotonsillectomy is one of the most common surgical procedures worldwide. The current standard for securing the airway in patients undergoing adenotonsillectomy is endotracheal tube (ETT) intubation. Several studies have investigated the use of the laryngeal mask airway (LMA) in this procedure. We conducted a systematic review and meta-analysis to compare the safety and efficacy of the LMA versus ETT in adenotonsillectomy.

methodDatabases were searched from inception to 2022 for randomized controlled trials and comparative studies. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The primary outcome is the rate of perioperative respiratory adverse events (PRAEs). Secondary outcomes included the rate of conversion to ETT, desaturations, nausea/vomiting, and surgical time. A subgroup analysis, risk of bias, publication bias, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessments were also performed.

resultsTwelve studies were included in the analysis (4176 patients). The mean overall conversion to ETT was 8.36% [95% confidence interval (CI) = 8.17, 8.54], and for the pediatric group 8.27% (95% CI = 8.08, 8.47). The mean rate of conversion to ETT secondary to complications was 2.89% (95% CI = 2.76, 3.03) while the rest was from poor surgical access. Overall, there was no significant difference in PRAEs [odds ratio (OR) 1.16, 95% CI = 0.60, 2.22], desaturations (OR 0.79, 95% CI = 0.38, 1.64), or minor complications (OR 0.89, 95% CI = 0.50, 1.55). The use of LMA yielded significantly shorter operative time (mean difference -4.38 minutes, 95% CI = -8.28, -0.49) and emergence time (mean difference -4.15 minutes, 95% CI = -5.63, -2.67).

conclusionFor adenotonsillectomy surgery, LMA is a safe alternative to ETT and requires less operative time. Careful patient selection and judgment of the surgeon and anesthesiologist are necessary, especially given the 8% conversion to ETT rate.

Indexed as

AdenoidectomyLaryngeal MasksTonsillectomyHumansIntubation, IntratrachealPostoperative Complicationsadenotonsillectomyairway managementendotracheal tubelaryngeal mask airwayLMAmeta-analysispediatric adenotonsillectomypediatric anesthesiapostoperative outcomessystematic review

Identifiers

PMID38899617
PMCPMC11191617

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.