Sedation for awake tracheal intubation: A systematic review and network meta‐analysis
Authors' conclusion
To maximise effective and safe awake tracheal intubation, optimising oxygenation, topical airway anaesthesia and procedural performance may have more impact than any given sedation regimen.
Study context
- Population
- Patients undergoing awake tracheal intubation for any indication
- Participants
- 2,837 patients · 48 studies
- Comparison
- Sedation regimens for awake tracheal intubation
- Outcome
- Overall tracheal intubation success rate
Methodological detailsfrequentist network meta-analysis, sensitivity analysis excluding high risk of bias trials
- Frequentist network meta-analysis
- Sensitivity analysis excluding high risk of bias trials
Pooled result
As reported in the abstract
Overall awake tracheal intubation success (38 studies, 2139 patients)
- No evidence that any individual sedation regimen was superior
Further pooled results
Time to successful tracheal intubation (24 studies, 1745 patients)
- Any sedation strategy superior to placebo
- Excluding high risk of bias trials: no evidence of a difference between any interventions
Safety
Arterial oxygen desaturation (31 studies, 1753 patients)
- Dexmedetomidine and magnesium sulphate associated with reduced risk vs other interventions
- Excluding high risk of bias trials: no relevant differences between interventions
- Quality of evidence low
Original publication
Sedation for awake tracheal intubation: A systematic review and network meta‐analysis. Anaesthesia. Published 28 October 2024. doi:10.
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