Objective: To determine the efficacy of ventilatory techniques by evaluating prevalence of technique failure and intraoperative hypoxia during endoscopic management of airway stenosis.
Data Sources: A systematic review was conducted using PubMed and Embase for anesthesia techniques in endoscopic management of airway stenosis.
Review Methods: The primary outcome measured was reports of partial and complete technique failure. The secondary outcome measured was intraoperative hypoxia.
Results: We identified 7704 abstracts with 17 meeting criteria for analysis. The reported partial and complete ventilatory technique failures were: 0 % Evone Flow-Controlled Ventilation with Tritube endotracheal tube, 0 % laryngeal mask airway, 0 % nonocclusive balloon dilator, 4.76 % spontaneous respiration using intravenous anesthesia and Hi-flow nasal oxygen, and 30.24 % jet ventilation. The reported rate of intraoperative hypoxia was: 0 % Evone Flow-Controlled Ventilation with Tritube endotracheal tube, 0 % spontaneous respiration using intravenous anesthesia and Hi-flow nasal oxygen, 2.18 % jet ventilation, 3.57 % laryngeal mask airway, and 5 % nonocclusive balloon dilator.
Conclusion: Evone Flow-Controlled Ventilation with Tritube endotracheal tube had the lowest risk of technique failure and intraoperative hypoxia. Nonocclusive balloon dilator and laryngeal mask airway were also favorable techniques for ventilation. Jet ventilation showed a lower rate of intraoperative hypoxia, but a higher rate of failure. Newer techniques, such as Evone Flow-Controlled Ventilation with Tritube, nonocclusive balloon dilator and spontaneous respiration using intravenous anesthesia and Hi-flow nasal oxygen, may offer promise compared to older techniques like jet ventilation; however, larger studies with more uniform data are needed to determine their efficacy.
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