Comparative analysis of supraglottic airway vs. infraglottic airway in endoscopic retrograde cholangiopancreatography: a systematic review and meta-analysis.
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Aim: To compare the efficacy and safety of supraglottic airway (SGA) vs. infraglottic airway (IGA) in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Background: To optimize patient outcomes by improving airway control, various airway techniques have been employed for sedation during ERCP. However, there is uncertainty about the noninferiority of SGA devices compared to IGA. Methods: We performed a systematic review in PubMed, Embase, and Cochrane Library databases, searching for randomized and non-randomized studies comparing SGA vs. IGA in patients undergoing ERCP and reporting at least one of the outcomes of interest. The primary outcomes were procedure time, incidence of hypoxia, and blood staining events. Statistical analyses were performed using R language 4.3.1. Odds ratio (OR) was used for binary outcomes and mean difference (MD) for continuous outcomes with their respective 95% confidence interval (CI). Heterogeneity was assessed using the Cochran Q test and I² statistics. Results: The study comprised 1 randomized controlled trial (RCT) and 3 observational studies involving 280 patients. Among them, 160 were allocated to the SGA group and 120 to the IGA group. When comparing procedure times, there was no statistically significant difference between SGA and IGA (MD -1.51 minutes; 95% CI -6.10 to 3.09 minutes; p = 0.52; I² = 62%). Regarding blood staining, statistical significance favored IGA over SGA (OR 2.67; 95% CI 1.12 to 6.41, p = 0.027; I² = 0%). Conclusion: No statistically significant difference in procedure time was observed between SGA and IGA. However, IGA exhibited a favorable outcome regarding reduced blood staining compared to SGA. Further studies comparing similar outcomes are necessary to assess such associations better.
Institutions: Universidade Federal de Ciências da Saúde de Porto Alegre, Beth Israel Deaconess Medical Center, Harvard University, Universidade Federal de Pernambuco, Universidade Federal de Juiz de Fora, Pontifícia Universidade Católica do Rio Grande do Sul, Hospital de Câncer de Barretos, Duke Medical Center
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4412785250