A total of 53 randomized control trials that included 4695 patients and 28 anesthetic combinations during GA induction and LMA insertion were included in the NMA. Propofol was used as the only comparator against other anesthetics. The primary outcome analyzed was prolonged apnea, with secondary outcomes of adverse airway events, LMA insertion failure, inadequate depth of anesthesia, and hemodynamic events.
Researchers found an apnea incidence rate of 33.3% (mean time of 3.74 ± 3.56 minutes). When compared against all propofol combinations, other than the propofol and thiopental combination, propofol alone was found to be the least effective at reducing adverse effects; the propofol and dexmedetomidine combination was found to be the most effective for reducing adverse outcomes during LMA insertion.
The research presented in this study appears to be the first of its kind to compare and rank the effectiveness of all anesthetic combinations used for GA induction during LMA insertion, with the propofol and dexmedetomidine combination being the most effective. Goertzen and colleagues conclude, “The NMA method allows for direct and indirect comparisons of multiple treatments when head-to-head comparisons are not always available in the literature. In the studies that met our inclusion criteria, 48 different anesthetics and anesthetic combinations were identified. This study demonstrates that the comparison of different anesthetic combinations with an NMA is feasible and effective.”
Full text of the article, “Comparison of Anesthetics for Laryngeal Mask Airway Insertion: A Network Meta-Analysis,” Anesthesia Progress, Vol. 71, No. 2, 2024, is now available at https://anesthesiaprogress.kglmeridian.com/view/journals/anpr/71/2/article-p58.xml
About Anesthesia Progress
Anesthesia Progress is the official publication of the American Dental Society of Anesthesiology (ADSA). The quarterly journal is dedicated to providing a better understanding of the advances being made in the science of pain and anxiety control in dentistry. The journal invites submissions of review articles, reports on clinical techniques, case reports, and conference summaries. To learn more about the ADSA, visit: http://www.adsahome.org/.
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