• Yuqi Liu, Lianhua Chen, and Shitong Li.
• Anesthesiology Department of Obstetrics and Gynecology, Hospital of FuDan University, Shanghai, China.
• Paediatr Anaesth. 2014 Oct 1;24(10):1023-30.

BackgroundEither controlled ventilation or spontaneous respiration is commonly used in general anesthesia for inhaled foreign body removal via rigid bronchoscopy. Controversy in the literature exists concerning which form of ventilation is optimally suited for bronchoscopy. We performed a meta-analysis to compare controlled ventilation and spontaneous respiration with respect to complications, operation time, and anesthesia recovery time.MethodsWe searched MEDLINE (1946-2013) and the Cochrane Central Register of Controlled Trials, EMBASE. The articles were evaluated for validity, and the data on complications, including desaturation, laryngospasm, laryngeal edema, bucking and coughing, body movement, breath holding, operation time, and anesthesia recovery time, were extracted by the authors and summarized using odds ratios, mean differences, and 95% confidence intervals (CIs).ResultsFrom the included studies, 423 subjects received controlled ventilation, whereas 441 subjects received spontaneous respiration. There was no significant difference in the incidence of desaturation between controlled ventilation and spontaneous respiration (odds ratio, 0.70; 95% CI, 0.30-1.63). However, the incidence of laryngospasm was lower when controlled ventilation was performed (OR, 0.27; 95% CI, 0.10-0.76). The operation time (mean difference, -9.07 min; 95% CI, -14.03 to -4.12) was shorter in the controlled ventilation group.ConclusionsCurrent evidence does not show a preference for either controlled ventilation or spontaneous respiration, although laryngospasm has a lower incidence when controlled ventilation is performed. Additional clinical studies are required to substantiate this issue.© 2014 John Wiley & Sons Ltd.

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