THE IMPACT OF ENDOTRACHEAL TUBE VS. LARYNGEAL MASK AIRWAY ON THE INCIDENCE OF POSTOPERATIVE NAUSEA AND VOMITING: A SYSTEMIC REVIEW AND META-ANALYSIS.

Middle East Journal of Anesthesiology Pub Date : 2015-02-01

Jahan Porhomayon, Sina Davari Farid, Ali A El-Solh, Ghazaleh Adlparvar, Nader D Nader

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Abstract

Objective: To investigate the impact of Endotracheal tube (ETT) vs. Laryngeal Mask Airway (LMA) on postoperative nausea and vomiting (PONV) in patients undergoing surgery with general anesthesia.

Methods: Key words searching from databases such as Medline, Embase, and Cochrane library provided 14 studies focusing on the use of EET vs. LMA for general anesthesia. Pooled estimate of relative risk with 95% confidence interval using random effect model was conducted.

Results: 14 studies were selected for meta-analysis with a total of 1866 patients. 9 studies focused on the outcome of PONV in adult patients. It showed incidence of PONV with of LMA and ETT in adult of about 204/690 (30%) and 145/725 (20%) respectively with [Odds Ratio (OR) = 1.69, 95% CI, 0.76-3.75, P = 0.20]. Heterogeneity was high (I2 = 87%). Five studies focused on the outcome of PONV in pediatric patients with PONV in LMA and ETT group of 85/229 (37%) and 72/222 (32%) respectively with (OR = 1.30, 95% CI, 0.61-2.76, P = 0.50). Heterogeneity was moderate at (I2 = 53%). When all patients were combined heterogeneity was high at 81% with OR = 1.56, 95% CI, 0.87-2.79, P = 0.14.

Conclusion: Risk of PONV shows an increase trend toward the use of LMA. Larger randomized trials are needed to assess the impact of airway devices on PONV.

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气管插管与喉罩通气对术后恶心呕吐发生率的影响：一项系统综述和荟萃分析。

目的：探讨气管插管（ETT）与喉罩气道（LMA）对全麻手术患者术后恶心呕吐（PONV）的影响。方法：从Medline、Embase和Cochrane图书馆等数据库中检索关键词，提供了14项研究，重点是EET与LMA在全麻中的应用。使用随机效应模型对95%置信区间的相对风险进行了汇总估计。结果：选择了14项研究进行荟萃分析，共有1866名患者。9项研究集中于成人患者PONV的结果。LMA和ETT的PONV在成人中的发生率分别为204/690（30%）和145/725（20%），[比值比（OR）=1.69，95%CI，0.76-3.75，P=0.20]。五项研究集中于LMA和ETT组儿童PONV患者的PONV结果，分别为85/229（37%）和72/222（32%），（OR=1.30，95%CI，0.61-2.76，P=0.50）。异质性中等（I2=53%）。当所有患者合并时，异质性高达81%，OR=1.56，95%CI，0.87-2.79，P=0.014。结论：随着LMA的使用，PONV的风险呈增加趋势。需要进行更大规模的随机试验来评估气道装置对PONV的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Middle East Journal of Anesthesiology Medicine-Anesthesiology and Pain Medicine

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0.20

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期刊介绍： The journal is published three times a year (February, June, and October) and has an Editorial Executive Committee from the department and consultant editors from various Arab countries. A volume consists of six issues. Presently, it is in its 42nd year of publication and is currently in its 19th volume. It has a worldwide circulation and effective March 2008, the MEJA has become an electronic journal. The main objective of the journal is to act as a forum for publication, education, and exchange of opinions, and to promote research and publications of the Middle Eastern heritage of medicine and anesthesia.