A systematic review and meta‐regression analysis of mivacurium for tracheal intubation |
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| Authors: | L. E. H. Vanlinthout S. H. Mesfin N. Hens B. F. Vanacker E. N. Robertson L. H. D. J. Booij |
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| Affiliation: | 1. Department of Anaesthesiology, Radboud University Medical Centre Nijmegen, , Nijmegen, The Netherlands;2. Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I‐BIOSTAT), Universities of Leuven and Hasselt, , Leuven and Diepenbeek, Belgium;3. Department of Anaesthesiology, University Hospitals Leuven, , Leuven, Belgium |
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| Abstract: | We systematically reviewed factors associated with intubation conditions in randomised controlled trials of mivacurium, using random‐effects meta‐regression analysis. We included 29 studies of 1050 healthy participants. Four factors explained 72.9% of the variation in the probability of excellent intubation conditions: mivacurium dose, 24.4%; opioid use, 29.9%; time to intubation and age together, 18.6%. The odds ratio (95% CI) for excellent intubation was 3.14 (1.65–5.73) for doubling the mivacurium dose, 5.99 (2.14–15.18) for adding opioids to the intubation sequence, and 6.55 (6.01–7.74) for increasing the delay between mivacurium injection and airway insertion from 1 to 2 min in subjects aged 25 years and 2.17 (2.01–2.69) for subjects aged 70 years, p < 0.001 for all. We conclude that good conditions for tracheal intubation are more likely by delaying laryngoscopy after injecting a higher dose of mivacurium with an opioid, particularly in older people. |
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