• Yoshihiro Hirabayashi, Hiroshi Hoshijima, and Norifumi Kuratani.
• Department of Anesthesiology, International University of Health and Welfare, Nasushiobara 329-2763.
• Masui. 2013 Jul 1;62(7):886-93.

BackgroundThe aim of this meta-analysis was to assess the efficacy of the channeled videolaryngoscopes in routine tracheal intubation.MethodsThe systematic search, data extraction, critical appraisal, and pooled analysis were performed according to the PRISMA statement. We included randomized controlled trials in humans comparing Airtraq and Pentax-AWS to Macintosh laryngoscopy regarding the successful first-attempt and time for instrumentation. The relative risk (RR), mean difference (MD), and their corresponding 95% confidence intervals (CIs) were calculated for dichotomous and continuous outcomes, respectively.ResultsWe included 20 trials with total of 2,370 patients. The channeled videolaryngoscopes showed higher success rate (RR 1.103, 95%CI 1.042 to 1.167, P <0.00069) and shorter duration for instrumentation (MD-10.873 s, 95%CI-18.588 s to-3.158 s, P< 0.0057). In studies examining novice laryngoscopists, successful first-attempt intubation (RR 1.28, 95%CI 1.14 to 1.45, P<0.000067) and time for instrumentation (MD-22.9 s, 95%CI-29.4 to-16.4, P<0.00001) were improved using the channeled videolaryngoscopes. With respect to experts' hands, there was no difference between the two devices in both of these outcomes for non-difficult intubations, while successful first-attempt intubation was improved for difficult intubations (RR 1.09, 95%CI 1.05 to 1.15, P<0.00011).ConclusionsCompared to the Macintosh laryngoscopy, channeled videolaryngoscopy offers advantages for novice laryngoscopists, while these benefits are not seen with experts' hands in normal airways. Even with skillful hands, channeled videolaryngoscopy improves the successful first-attempt intubation in difficult intubations.

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