SynthesisAnaesthesia2025
Sedation for awake tracheal intubation: A systematic review and network meta-analysis.
Synthesis in Anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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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.
The trial behind it
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Who cites it
8 citing papers in PubMed.
- Efficacy and safety of remimazolam combined with remifentanil for sedation during awake fiberoptic intubation: a randomized controlled trial.Annals of medicine · 2025Trial
- Efficacy and Safety of Remimazolam versus Dexmedetomidine and Midazolam in Awake Endotracheal Intubation for Difficult Airway Patients: A Randomized Controlled Study.Drug design, development and therapy · 2025Trial
- Airway management in critically ill patients with obesity.Intensive care medicine · 2026Review
- Article
- Preserving Airway Reflexes During Awake Intubation: A Cautionary Note on Deep Sedation Protocols [Response to Letter].Drug design, development and therapy · 2026Article
- Preserving Airway Reflexes During Awake Intubation: A Cautionary Note on Deep Sedation Protocols [Letter].Drug design, development and therapy · 2026Article
- Successful awake tracheal intubation in a morbidly obese patient with severe obstructive sleep apnea-hypopnea syndrome and a giant vocal cord polyp: A case report.The Journal of international medical research · 2025Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferent sedation regimens have been used to facilitate awake tracheal intubation, but the evidence has not been synthesised robustly, particularly with respect to clinically important outcomes. We conducted a systematic review and network meta-analysis to determine the sedation techniques most likely to be associated with successful tracheal intubation, a shorter time to successful intubation and a lower risk of arterial oxygen desaturation.
methodsWe searched for randomised controlled trials of patients undergoing awake tracheal intubation for any indication and reporting: overall tracheal intubation success rate; tracheal intubation time; incidence of arterial oxygen desaturation; and other related outcomes. We performed a frequentist network meta-analysis for these outcomes if two or more sedation regimens were compared between included trials. We also performed a sensitivity analysis excluding trials with a high risk of bias.
resultsIn total, 48 studies with 2837 patients comparing 33 different regimens were included. Comparing overall awake tracheal intubation success rates (38 studies, 2139 patients), there was no evidence suggesting that any individual sedation regimen was superior. Comparing times to successful tracheal intubation (1745 patients, 24 studies), any sedation strategy was superior to placebo. When we excluded trials with a high risk of bias, we found no evidence of a difference between any interventions for time to successful tracheal intubation. Thirty-one studies (1753 patients) suggested that dexmedetomidine and magnesium sulphate were associated with a reduced risk of arterial oxygen desaturation compared with other interventions, but excluding trials with a high risk of bias suggested no relevant differences between interventions. The quality of evidence for each of our outcomes was low.
conclusionsTo maximise effective and safe awake tracheal intubation, optimising oxygenation, topical airway anaesthesia and procedural performance may have more impact than any given sedation regimen.
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