Airway nerve blocks for awake tracheal intubation: A meta-analysis of randomized control trials and trial sequential analysis

作者：Jianqiao Zheng, Li Du, Bin Du, Weiyi Zhang, Lu Zhang, Guo Chen · 发表于：Journal of Clinical Anesthesia · 年份：2023 · DOI：10.1016/j.jclinane.2023.111122 · 被引用次数：24 · 研究领域：Airway Management and Intubation Techniques、Anesthesia and Sedative Agents、Anesthesia and Pain Management

STUDY OBJECTIVE: This systematic review and meta-analysis aimed to assess the superiority of airway nerve blocks versus airway anesthesia without nerve blocks for awake tracheal intubation (ATI). DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs). SETTING: All studies that assessed the superiority of airway anesthesia technique for awake tracheal intubation were searched in PubMed, Web of Science, Cochrane Library, Ovid Medline, Embase and Chinese databases (including China National Knowledge Infrastructure, Wanfang database, and VIP databases) and trial registry databases from their inception to December 2022. PATIENTS: Adult patients included in randomized controlled trials comparing airway anesthesia with or without airway nerve blocks for ATI. INTERVENTIONS: Airway nerve (including superior laryngeal nerve, glossopharyngeal nerve, or recurrent laryngeal nerve) blocks for ATI. MEASUREMENTS: The primary outcome was the intubation time. Secondary outcomes were quality of intubating conditions (including patient reaction to placement of the flexible scope and tracheal tube, coughing and gagging, and patient satisfaction) and overall complications during ATI. MAIN RESULTS: Fourteen articles with 658 patients were identified for analysis. When compared with airway anesthesia without nerve blocks, airway nerve blocks significantly reduced intubation time (standardized mean difference [SMD] -2.57, 95% CI -3.59- -1.56, p < 0.00001), improved anesthe...