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Updated: Sep 20, 2025
05:43
Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
Published on: January 13, 2017
16.8K
Awake Versus Asleep Intubation for Mediastinal Goiters: A Systematic Review and Meta-Analysis
Lindsay E Booth1, Norbert Banyi1, Peter Rose2
1Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Summary
The risk of failed intubation for mediastinal goiters is low, with a 0.3% incidence. While awake intubation is often preferred, asleep intubation also shows high success rates for these complex cases.
Area of Science:
- Anesthesiology
- Otorhinolaryngology
Background:
- Mediastinal goiters present anesthetic challenges, often necessitating awake intubation.
- Awake intubation, while effective, can be resource-intensive and uncomfortable for patients.
Purpose of the Study:
- To compare the outcomes of awake versus asleep intubation in patients undergoing thyroidectomy for mediastinal goiters.
Main Methods:
- A systematic review following PRISMA 2020 guidelines.
- Searched multiple databases (Medline, Embase, Web of Science, CINAHL, Scopus, Cochrane).
- Included 12 studies with 1002 patients, using a 3-level random-effects model for analysis.
Main Results:
- The overall failed intubation rate was low at 0.3% (3 cases).
- The uncomplicated intubation rate was 91% overall.
- Awake intubation showed a 96% success rate, while asleep intubation had an 88% success rate.
Conclusions:
- Failed intubation for mediastinal goiters is uncommon.
- Asleep intubation is a viable and effective option, with high success rates.
- Further research is needed to standardize definitions of intubation difficulty.
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