Videolaryngoscopy vs. direct laryngoscopy in class 2 and 3 obesity: a systematic review, meta‐analysis and trial sequential analysis of randomised controlled trials*
Authors' conclusion
In patients living with class 2 or 3 obesity, videolaryngoscopy significantly reduced failed tracheal intubation incidence, first-attempt failure incidence, incidence of hypoxaemia and poor glottic visualisation.
Study context
- Population
- Adults with class 2 or 3 obesity (BMI ≥ 35 kg.m-2) undergoing elective general surgery
- Participants
- 955 adults · 10 trials
- Comparison
- Videolaryngoscopy vs direct laryngoscopy
- Videolaryngoscopyn = 481
- Direct laryngoscopyn = 474reference
- Outcome
- Failed tracheal intubation; hypoxaemia; first attempt tracheal intubation failure
Methodological detailstrial sequential analysis
- Trial sequential analysis
Pooled result
As reported in the abstract
Videolaryngoscopy vs Direct laryngoscopyRelative risk (95% CI)P value
Failed tracheal intubation; nine studies
0.15(0.05–0.35)
P < 0.001Hypoxaemia; seven studies
0.21(0.10–0.43)
P < 0.001First attempt failure; seven studies
0.44(0.25–0.76)
P = 0.004Further pooled results
Glottic visualisation
- Significantly improved with videolaryngoscopy
Time to tracheal intubation, sore throat, intubation difficulty scale
- No significant difference
Original publication
Videolaryngoscopy vs. direct laryngoscopy in class 2 and 3 obesity: a systematic review, meta‐analysis and trial sequential analysis of randomised controlled trials*. Anaesthesia. Published 8 April 2025. doi:10.
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