Efficacy of laryngeal mask airway against postoperative pharyngolaryngeal complications following thyroid surgery: a systematic review and meta-analysis of randomized controlled studies.

I-Wen Chen, Chih-Wei Hsu, Kuo-Chuan Hung, Shao-Chun Wu, Ching-Chung Ko, Jui-Yi Chen, Ping-Wen Huang, Cheuk-Kwan Sun

Journal: Scientific reports 2022;12(1):18210

PMID: 36307459

Abstract

This meta-analysis aimed at investigating the effectiveness of laryngeal mask airway (LMA) against postoperative pharyngolaryngeal complications after thyroidectomy. MEDLINE, Cochrane Library, google scholar, and EMBASE databases were searched from inception through February, 2021, for randomized controlled trials (RCTs) comparing the incidence of pharyngolaryngeal complications following the use of LMA or endotracheal tube (ETT). Pooled results from seven RCTs involving 600 patients showed an association of LMA with a reduced risk of postoperative sore throat (POST) at 24 h [risk ratio (RR) 0.75, p = 0.006, four trials], but not at 1 h and 48 h after thyroidectomy. POST severity and hoarseness risk were lower in the LMA group than the ETT group at 1 h, 24 h, and 48 h (all p < 0.05). Nevertheless, hoarseness severity was lower in the LMA group only at postsurgical 48 h [standardized mean difference = - 0.35, p = 0.008, three trials]. Moreover, the risk of emergence cough was lower in patients using LMA than those receiving ETT (RR = 0.14, p = 0.002, two trials). The two groups did not differ in the severity of dysphagia at postoperative 1 h, 24 h, and 48 h. This meta-analysis showed that LMA may be associated with fewer pharyngolaryngeal complications compared to ETT without airway impacts. The limited number of included studies warrants further research to support our findings.

© 2022. The Author(s).

Address: Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.; Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.; Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.; Department of Medical Imaging, Chi Mei Medical Center, Tainan, Taiwan.; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.; Department of Health and Nutrition, ChiaNai University of Pharmacy and Science, Nanjing, China.; Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.; Department of Emergency Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan.; Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan.; Department of Emergency Medicine, E-Da Hospital, No.1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 82445, Taiwan. [email protected].; College of Medicine, I-Shou University, Kaohsiung, Taiwan. [email protected].
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