• PietersB M ABMADepartment of Anaesthesia, University Medical Centre Utrecht, Utrecht, the Netherlands., E H A Maas, KnapeJ T AJTADepartment of Anaesthesia, University Medical Centre Utrecht, Utrecht, the Netherlands., and van ZundertA A JAAJDepartment of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Brisbane, Qld, Australia..
• Department of Anaesthesia, University Medical Centre Utrecht, Utrecht, the Netherlands.
• Anaesthesia. 2017 Dec 1; 72 (12): 1532-1541.

AbstractExperienced anaesthetists can be confronted with difficult or failed tracheal intubations. We performed a systematic review and meta-analysis to ascertain if the literature indicated if videolaryngoscopy conferred an advantage when used by experienced anaesthetists managing patients with a known difficult airway. We searched PubMed, MEDLINE, Embase and the Cochrane central register of controlled trials up to 1 January 2017. Outcome parameters extracted from studies were: first-attempt success of tracheal intubation; time to successful intubation; number of intubation attempts; Cormack and Lehane grade; use of airway adjuncts (e.g. stylet, gum elastic bougie); and complications (e.g. mucosal and dental trauma). Nine studies, including 1329 patients, fulfilled the inclusion criteria. First-attempt success was greater for all videolaryngoscopes (OR 0.34 (95%CI 0.18-0.66); p = 0.001). Use of videolaryngoscopy was associated with a significantly better view of the glottis (Cormack and Lehane grades 1 and 2 vs. 3-4, OR 0.04 (95%CI 0.01-0.15); p < 0.00001). Mucosal trauma occurred less with the use of videolaryngoscopy (OR 0.16 (95%CI 0.04-0.75); p = 0.02). Videolaryngoscopy has added value for the experienced anaesthetist, improving first-time success, the view of the glottis and reducing mucosal trauma.© 2017 The Association of Anaesthetists of Great Britain and Ireland.

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