Objective:

To compare the efficacy and safety of endoscopy-specific dual-channel supraglottic airways (dc-SGAs) with endotracheal tubes, other airway devices, and non-invasive oxygen therapy during upper gastrointestinal endoscopic and transesophageal procedures.

Approach:

• Systematic Review and Meta-Analysis: Conducted a systematic review and meta-analysis of randomized controlled trials comparing dc-SGAs with various airway management strategies during upper GI endoscopic procedures.

Key Findings:

• Endoscopy-specific dc-SGAs showed comparable first-attempt airway device and endoscope/probe insertion success to comparator strategies.
• dc-SGAs shortened airway device insertion time.
• Intraoperative hypoxemia was reduced with dc-SGAs, particularly compared to non-invasive oxygen therapy.
• Postoperative sore throat events were fewer with dc-SGAs compared to endotracheal tubes but more frequent compared to non-invasive oxygen therapy.

Interpretation:

dc-SGAs may improve airway placement efficiency and reduce hypoxemia compared to non-invasive oxygen therapy, but the benefits are tempered by varying rates of throat discomfort and evidence certainty.

Limitations:

• Evidence is low-to-moderate in certainty.
• Procedures included in the review were heterogeneous.
• Postoperative sore throat outcomes were dependent on the comparator used.

Conclusion:

Endoscopy-specific dc-SGAs may represent an intermediate airway strategy for selected patients undergoing upper gastrointestinal endoscopic and transesophageal procedures.

Sources:

• Systematic Review Registration