Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1242
Peer-review started: September 26, 2021
First decision: October 18, 2021
Revised: October 26, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: February 6, 2022
Processing time: 119 Days and 19.3 Hours
The inflatable Ambu laryngeal masks and non-inflatable i-gel are two widely used paediatric supraglottic airway devices (SGAs) in routine anaesthesia and served as primary or back-up devices for difficult airway management. However, the clinical performance and safety of the two devices in paediatric patients are still unclear and warrant further investigation.
In this study, we aimed to perform a systematic review and meta-analysis on the clinical performance and safety of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients. The results of this study may provide clinical evidence for the application of laryngeal mask in anaesthetised paediatric patients.
To perform a systematic review and meta-analysis on the clinical performance and safety of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients.
We identified published randomised controlled trials (RCTs) in which the intervention involved the use of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients (age < 18 years) in MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials from the inception dates to April 20, 2020 . We assessed the oropharyngeal leak pressure (OLP) as the primary outcome. The secondary outcomes were insertion time, success rate of insertion on the first attempt, and incidence of adverse events.
Data from seven RCTs with a total of 667 paediatric patients were evaluated and showed that the mean OLP and the incidence of adverse events was lower in the non-inflatable i-gel group in anaesthetised paediatric patients.
The non-inflatable i-gel airway may provide a better seal with a low risk of adverse events and is therefore probably more suitable than the inflatable Ambu laryngeal mask airway in anaesthetised paediatric patients. However, the evidence is insufficient to allow making firm conclusions or to guide clinical practice, owing to the small number of relevant published studies.
Further high-quality clinical studies of the application of laryngeal masks in anaesthetised paediatric patients are required to confirm our results.