• Yoshihiro Hirabayashi, Hiroshi Hoshijima, and Norifumi Kuratani.
• Department of Anesthesiology, International University of Health and Welfare, Nasushiobara 329-2763.
• Masui. 2013 Jun 1;62(6):737-44.

BackgroundIncreased evidence indicates that the Pentax-AWS (AWS) is useful for difficult airways. The aim of this meta-analysis was to assess the efficacy of the AWS in difficult airways, comparing that of Macintosh laryngoscopy.MethodsThe systematic search, data extraction, critical appraisal, and pooled analysis were performed according to the PRISMA statement. The relative risk (RR), mean difference (MD), and their corresponding 95% confidence intervals (CIs) were calculated by the Comprehensive Meta-analysis version 2.2.040 software for dichotomous and continuous outcomes, respectively.ResultsEighteen randomized controlled trials, performed in simulated difficult airways (published between 2006, October and 2012, May), included 981 tracheal intubations by AWS and 986 tracheal intubations by Macintosh laryngoscopy. AWS showed higher success rate (RR: 1.220, 95% CI: 1.126 to 1.322, P < 0.00001) and shorter duration for instrumentation (MD: -10.319 s, 95% CI: -14.309 s to -6.328 s, P < 0.00001).ConclusionsThere is considerable evidence that AWS has an advantage over Macintosh laryngoscope in difficult airways.

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