ng SGD, and replaced Fastrach in many institutions. However, there is uncertainty regarding the comparison between these devices in terms of efficacy for intubation and ventilation, and safety in an airway rescue situation. METHODS: PubMed, EMBASE, Scopus, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing I-gel and Fastrach SGD in adult patients undergoing intubation. The primary outcome was the first-pass success rate for tracheal intubation. Secondary outcomes were tracheal intubation time, SGD insertion time and success, and complications. We computed risk ratios (RRs) to assess binary end points and weighted mean differences (WMDs) for continuous outcomes, with corresponding 95% confidence intervals (CIs) for the primary outcome and its subgroup analysis (P < .05 was considered statistically significant) and 99% CI after Bonferroni correction for the secondary outcomes (P < .01 was considered statistically significant). RESULTS: This study included a total of 14 RCTs encompassing 1340 patients. The results indicated a significant difference in the first-pass success rate favoring Fastrach (RR, 0.81; 95% CI, 0.67–0.98; P = .03; I² = 91%). In the subgroup analysis, when a flexible scope was utilized through I-gel, providers achieved a better tracheal intubation first-pass success rate (RR, 1.05; 95% CI, 1.01–1.11; P = .03; I² = 0%), compared with the Fastrach. Overall intubation success rates (RR, 0.92; 99% CI, 0.82–1.04; P = .08, I² = 92%) and time (WMD - 1.03 seconds; 99% CI, -4.75 to 2.69; P = .48; I² = 84%) showed no significant difference irrespective of the device used. There was no significant difference regarding device insertion time by the providers (WMD -6.48 seconds; 99% CI, -13.23 to 0.27; P = .01; I2 = 98%). Success rates of the providers’ initial SGD insertion and complications such as sore throat (RR, 1.01; 99% CI, 0.65–1.57; P = .95, I² = 33%) and blood presence post-SGD removal (RR, 0.89; 99% CI, 0.42–1.86; P = .68, I² = 0%) showed no significant difference. CONCLUSIONS: Based on our findings, a higher first-pass success rate was observed with the use of Fastrach when compared to I-gel. However, the use of I-gel might result in a better intubation success rate with the flexible scope-guided intubation. There are no significant differences in performance in terms of the success rate for intubation overall, time for device insertion, or time to intubation or complications regardless of the device used....

中文翻译：

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I-gel 和 Fastrach 喉罩气道作为成人插管装置的临床性能比较：系统评价和荟萃分析


ng SGD，并在许多机构中取代了 Fastrach。然而，这些设备在插管和通气的有效性以及气道救援情况下的安全性方面的比较存在不确定性。方法： 检索 PubMed 、 EMBASE 、 Scopus 和 Cochrane 数据库，查找比较 I-gel 和 Fastrach SGD 在接受插管的成年患者中的随机对照试验 （RCT）。主要结局是气管插管的首次成功率。次要结局是气管插管时间、SGD 插入时间和成功率以及并发症。我们计算了风险比 （RRs） 来评估连续性结局的二进制终点和加权均数差 （WMD），主要结局及其亚组分析的相应 95% 置信区间 （CIs） （P < .05 被认为具有统计学意义）和 Bonferroni 校正后的 99% CI 次要结局 （P < .01 被认为具有统计学意义）。结果： 本研究共纳入 14 项 RCT，涉及 1340 例患者。结果表明，有利于 Fastrach 的首次通过成功率存在显著差异（RR，0.81;95% CI，0.67-0.98;P = .03;I² = 91%）。在亚组分析中，当通过 I-gel 使用灵活的范围时，提供者实现了更好的气管插管首次通过成功率（RR，1.05;95% CI，1.01-1.11;P = .03;I² = 0%），与 Fastrach 相比。总体插管成功率 （RR， 0.92;99% CI， 0.82–1.04;P = .08，I² = 92%）和时间（WMD - 1.03 秒;99% CI，-4.75 至 2.69;P = .48;I² = 84%） 显示无论使用何种设备均无显著差异。提供者在设备插入时间方面没有显著差异（WMD -6.48 秒;99% CI，-13.23 至 0.27;P = .01;I2 = 98%）。 提供者初始 SGD 插入和喉咙痛等并发症的成功率（RR，1.01;99% CI，0.65-1.57;P = .95，I² = 33%）和 SGD 去除后血液存在 （RR，0.89;99% CI，0.42-1.86;P = .68，I² = 0%） 显示无显著差异。结论： 根据我们的研究结果，与 I-gel 相比，使用 Fastrach 观察到更高的首次通过成功率。然而，使用 I-gel 可能会通过灵活的内窥镜引导插管获得更好的插管成功率。无论使用何种设备，在整体插管成功率、设备插入时间、插管时间或并发症方面，性能均无显著差异。