Serious airway complications can occur with inadequate airway management during general anesthesia (GA). This meta-analysis investigated randomized controlled trials that compared perioperative technique failures and airway complications, including hypoxia, during GA for dentistry using endotracheal intubation or a laryngeal mask airway (LMA) for airway management. A systematic search of electronic databases and gray literature was completed. Independent reviewers assessed eligibility, performed data extraction, completed risk of bias assessment, and judged the quality of results through Grading of Recommendations, Assessment, Development, and Evaluation. Risk ratios (RRs) for airway complications, with 95% CIs, were calculated. Heterogeneity was quantified using the I
2 statistic. Sensitivity and age-subgroup analyses were explored. Six trials were deemed eligible from a total of 9076 identified reports. The airway management intervention for these trials was LMA. Technique failures or effect differences in airway complications were not detected except for postoperative hypoxia, where LMA use had a decreased risk (RR, 0.22; 95% CI, 0.06-0.77; I
2 = 0%; moderate quality). A similar effect was seen in the pediatric analysis (RR, 0.10; 95% CI, 0.01-0.84; I
2 = 0%; moderate quality). Additionally, LMA use reduced pediatric sore throat risk (RR, 0.08; 95% CI, 0.04-0.15; I
2 = 0%; moderate quality). Use of an LMA in dentistry may have the potential to reduce the risk of postoperative hypoxia, particularly in pediatric patients, although further study is required.Objective:
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Study flow diagram.
(A) Risk of bias summary: judgments from authors on risk of bias domains among individual included studies. (B) Risk of bias summary: judgements from authors on risk of bias domains across all included studies
Forest plot for airway complications from all included studies.
Sensitivity analysis forest plot for airway complications from all included studies.
Age subgroup meta-analyses of airway complications presented in forest plot.
Contributor Notes
eISSN: 1878-7177
ISSN: 0003-3006