Abstract：
Conventionally, tracheal tubes have been used for general anesthesia in pediatric laparoscopic surgeries. Recently, supraglottic devices are being used for the same. The performance of supraglottic devices versus tracheal tubes in children undergoing laparoscopic surgery is uncertain.
A systematic review and meta-analysis of randomized controlled trials that compared supraglottic devices versus tracheal tubes in patients ≤18 years undergoing laparoscopic surgery under general anesthesia was conducted. The outcomes were peak airway pressures (cm H2 O), end-tidal carbon dioxide during pneumoperitoneum (mm Hg), recovery time (min), postoperative sore throat and adverse events. Mean difference and odds ratio, with 95% confidence intervals were reported using a random effect model.
Eight trials (n = 591) were included in the final meta-analysis. There was no statistically significant difference in the peak airway pressures (MD 0.58, 95% CI: -0.65 to 1.8; p = .36) and end-tidal carbon dioxide (MD -0.60, 95% CI: -2.00 to 0.80; p = .40) during pneumoperitoneum in the supraglottic device and the tracheal tube group. The tracheal tube group had higher odds of sore throat (OR 3.30, 95% CI: 1.69-6.45; p = .0005) and the supraglottic airway group had faster recovery time (MD 4.21, 95% CI: 3.12-5.31; p < .0001), which were statistically significant. The certainty of evidence is graded low.
There is low quality evidence to suggest that for pediatric laparoscopic surgeries of short duration, supraglottic devices could provide comparable intraoperative ventilation in terms of peak airway pressures and end tidal carbon dioxide, with lower odds of postoperative sore throat and faster recovery time when compared to tracheal tubes.
A systematic review and meta-analysis of randomized controlled trials that compared supraglottic devices versus tracheal tubes in patients ≤18 years undergoing laparoscopic surgery under general anesthesia was conducted. The outcomes were peak airway pressures (cm H2 O), end-tidal carbon dioxide during pneumoperitoneum (mm Hg), recovery time (min), postoperative sore throat and adverse events. Mean difference and odds ratio, with 95% confidence intervals were reported using a random effect model.
Eight trials (n = 591) were included in the final meta-analysis. There was no statistically significant difference in the peak airway pressures (MD 0.58, 95% CI: -0.65 to 1.8; p = .36) and end-tidal carbon dioxide (MD -0.60, 95% CI: -2.00 to 0.80; p = .40) during pneumoperitoneum in the supraglottic device and the tracheal tube group. The tracheal tube group had higher odds of sore throat (OR 3.30, 95% CI: 1.69-6.45; p = .0005) and the supraglottic airway group had faster recovery time (MD 4.21, 95% CI: 3.12-5.31; p < .0001), which were statistically significant. The certainty of evidence is graded low.
There is low quality evidence to suggest that for pediatric laparoscopic surgeries of short duration, supraglottic devices could provide comparable intraoperative ventilation in terms of peak airway pressures and end tidal carbon dioxide, with lower odds of postoperative sore throat and faster recovery time when compared to tracheal tubes.
摘要：
背景：通常，气管导管已用于小儿腹腔镜手术的全身麻醉。最近,乐上装置也被用于相同的用途。在接受腹腔镜手术的儿童中，声门上装置与气管导管的性能尚不确定。
方法：对一项随机对照试验进行了系统评价和荟萃分析，比较了在全身麻醉下接受腹腔镜手术的≤18岁患者的声门上装置与气管导管。结果为峰值气道压(cmH2O)，气腹期间潮气末二氧化碳（mmHg），恢复时间（分钟），术后喉咙痛和不良事件。平均差异和赔率比，使用随机效应模型报告95%置信区间.
结果：8项试验（n=591）纳入最终的meta分析。在气腹期间，声门上装置和气管导管组的气道峰值压（MD0.58，95％CI：-0.65至1.8；p=.36）和潮气末二氧化碳（MD-0.60，95％CI：-2.00至0.80；p=.40）没有统计学上的显着差异。气管导管组出现咽痛的几率较高(OR3.30,95%CI:1.69-6.45;p=.0005),声门上气道组恢复时间较快(MD4.21,95%CI:3.12-5.31;p<.0001),具有统计学意义。证据的确定性等级较低。
结论：有低质量的证据表明，对于持续时间短的小儿腹腔镜手术，声门上装置可以在气道峰值压力和呼气末二氧化碳方面提供相当的术中通气，与气管导管相比，术后喉咙痛的几率较低，恢复时间更快。
方法：对一项随机对照试验进行了系统评价和荟萃分析，比较了在全身麻醉下接受腹腔镜手术的≤18岁患者的声门上装置与气管导管。结果为峰值气道压(cmH2O)，气腹期间潮气末二氧化碳（mmHg），恢复时间（分钟），术后喉咙痛和不良事件。平均差异和赔率比，使用随机效应模型报告95%置信区间.
结果：8项试验（n=591）纳入最终的meta分析。在气腹期间，声门上装置和气管导管组的气道峰值压（MD0.58，95％CI：-0.65至1.8；p=.36）和潮气末二氧化碳（MD-0.60，95％CI：-2.00至0.80；p=.40）没有统计学上的显着差异。气管导管组出现咽痛的几率较高(OR3.30,95%CI:1.69-6.45;p=.0005),声门上气道组恢复时间较快(MD4.21,95%CI:3.12-5.31;p<.0001),具有统计学意义。证据的确定性等级较低。
结论：有低质量的证据表明，对于持续时间短的小儿腹腔镜手术，声门上装置可以在气道峰值压力和呼气末二氧化碳方面提供相当的术中通气，与气管导管相比，术后喉咙痛的几率较低，恢复时间更快。
