Effectiveness of indirect versus direct laryngoscopes for nasotracheal intubation in adults undergoing elective surgery: a systematic review and network meta-analysis
Authors' conclusion
In the present NMA to establish a ranking of the effectiveness of intubation devices in patients undergoing nasotracheal intubation, we found that most indirect laryngoscopes likely reduced intubation time, increased first-attempt success rates, and were more effective tracheal intubation devices for nasotracheal intubation compared with direct laryngoscopes
Study context
- Population
- Adults undergoing elective surgery with nasotracheal intubation22 studies
- Comparison
- Indirect vs direct laryngoscopes for nasotracheal intubation
- Outcome
- Intubation time
Methodological detailsfrequentist network meta-analysis, DerSimonian and Laird random-effects models
- Frequentist network meta-analysis
- DerSimonian and Laird random-effects models
Pooled result
As reported in the abstract
Intubation time (ranking)
| Group | P-score |
|---|---|
| C-MAC D-Blade | 0.98 |
| Macintosh | 0.07 |
P-score
C-MAC D-Blade0.98
Macintosh0.07
- Six indirect laryngoscopes significantly reduced intubation time vs Macintosh
- 6
Further pooled results
| Outcome | Values |
|---|---|
| First-attempt success rate (ranking) | C-MAC D-Blade P-score 0.78 · Airway Scope S100 P-score 0.06 |
| Glottic visualization (ranking) | Truview EVO2 P-score 0.79 · McCoy P-score 0.05 |
Original publication
Effectiveness of indirect versus direct laryngoscopes for nasotracheal intubation in adults undergoing elective surgery: a systematic review and network meta-analysis. Can J Anaesth. Published 24 March 2026. doi:10.
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