A Meta-Analysis of Comparative Analysis of Airway Management Techniques for Laparoscopic Surgeries

Introduction: The optimal airway management strategy for laparoscopic surgery remains controversial, with laryngeal mask airways (LMAs) and endotracheal tubes (ETs) as primary contenders. This systematic review and meta-analysis aim to compare these two approaches in the context of laparoscopic procedures. Materials and Methods: A systematic literature search was conducted in PubMed, Embase, Scopus, and Web of Science up to January 2024 to identify randomized controlled trials (RCTs) comparing LMA with ET for airway management during laparoscopic surgeries following PRISMA guidelines. Included studies were assessed for methodological quality. Data extraction and pooled analysis of effect sizes were performed using random-effects or fixed-effects models, as appropriate. Results: Thirty-one randomized controlled trials (RCTs) involving 4199 participants were included in the analysis. ET was associated with a significantly higher incidence of sore throat (RR: 0.56, 95% CI [0.48, 0.64]), hoarseness (RR: 0.41, 95% CI [0.32, 0.53]), nausea (RR: 0.65, 95% CI [0.49, 0.86]), vomiting (RR: 0.54, 95% CI [0.33, 0.86]), cough (RR: 0.16, 95% CI [0.12, 0.22]), and dysphagia (RR: 0.70, 95% CI [0.65, 0.89]) compared to LMA. No significant difference in blood staining was observed between the two groups. However, publication bias was detected for sore throat. Conclusions: ET use during laparoscopic surgery was associated with a higher incidence of postoperative complications compared to the LMA. These findings suggest that LMA may benefit patients by reducing complications and improving overall outcomes in this surgical setting. However, further research is necessary to confirm these results and uncover the underlying reasons for these differences.