Airway management and anaesthetic interventions for children with cleft lip and/or palate undergoing general anaesthesia: Protocol for a systematic review and meta-analysis
5 affiliations
- 1Department of Anatomy, Bangladesh Medical University, Dhaka, Bangladesh
- 2Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangladesh Medical University, Dhaka, Bangladesh
- 3Department of Orthodontics, Bangladesh Medical University, Dhaka, Bangladesh
- 4Department of Public Health and Informatics, Bangladesh Medical University, Dhaka, Bangladesh
- 5Department of Biostatistics, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh
Abstract
Background: Children with cleft lip and/or palate may present unique challenges during perioperative airway management because of altered upper-airway and craniofacial anatomy. These children frequently undergo surgical procedures requiring general anaesthesia and airway instrumentation. Several airway-management and anaesthetic techniques have been evaluated to facilitate tracheal intubation and reduce perioperative airway complications, but the comparative evidence from randomised controlled trials has not been systematically evaluated. Methods: This systematic review and meta-analysis will include randomised controlled trials involving children < 18 years with cleft lip and/or palate undergoing general anaesthesia. Eligible studies will compare alternative techniques or devices for airway management or other anaesthetic strategies between two groups of cleft lip/palate patients. The primary outcome will be difficulty in tracheal intubation. Where definitions vary substantially, outcomes will be analysed separately or synthesised narratively. Secondary outcomes will include difficult mask ventilation, oxygen desaturation, airway obstruction, difficult laryngoscopy, first-attempt intubation success, number of intubation attempts, time to successful intubation or airway establishment, failed intubation and other perioperative airway or respiratory adverse events. Two reviewers will independently select RCTs, extract data and assess risk of bias. Risk of bias will be evaluated using the Cochrane Risk of Bias 2 tool. Random-effects meta-analysis will be performed where clinically appropriate. Risk ratios will be used for dichotomous outcomes and mean differences or standardized mean differences for continuous outcomes. Certainty of evidence for important outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Registration and review status: The review was prospectively registered in PROSPERO on 10 March 2026 (CRD420261326076). Full-text screening and data extraction are ongoing and not yet complete. Protocol amendments are documented transparently in PROSPERO.
Related
- Effectiveness of non-pharmacological interventions on stress and anxiety management in pregnancy: a systematic review
- Influence of the anaesthetist´s perception on the evaluation of recovery quality in horses undergoing general anaesthesia
- Euchromatin Peripheral Organization Follows Anterograde Signalling Under Anaesthetic Stress
- Anaesthetic Considerations for Twin Delivery in a Patient With Osteogenesis Imperfecta Type III: A Case Report.
- Is plant-based protein supplementation as effective as whey protein? A systematic review and meta-analysis in untrained adults undergoing resistance training.
BibTeX
@article{sumi2026airway,
title = {{Airway management and anaesthetic interventions for children with cleft lip and/or palate undergoing general anaesthesia: Protocol for a systematic review and meta-analysis}},
author = {Sharmin Akter Sumi and Kazi Mahzabin Arin and Shahriar Mohd Shams and Tanzila Rafique and Keertika Orchi and Arna Chowdhury and Mohammad Meshbahur Rahman and Md Atiqul Haque},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0361327},
url = {https://doi.org/10.1371/journal.pone.0361327},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Airway management and anaesthetic interventions for children with cleft lip and/or palate undergoing general anaesthesia: Protocol for a systematic review and meta-analysis
AU - Sharmin Akter Sumi
AU - Kazi Mahzabin Arin
AU - Shahriar Mohd Shams
AU - Tanzila Rafique
AU - Keertika Orchi
AU - Arna Chowdhury
AU - Mohammad Meshbahur Rahman
AU - Md Atiqul Haque
PY - 2026
DA - 2026/10/27
JO - PLOS One
DO - 10.1371/journal.pone.0361327
UR - https://doi.org/10.1371/journal.pone.0361327
AB - Background: Children with cleft lip and/or palate may present unique challenges during perioperative airway management because of altered upper-airway and craniofacial anatomy. These children frequently undergo surgical procedures requiring general anaesthesia and airway instrumentation. Several airway-management and anaesthetic techniques have been evaluated to facilitate tracheal intubation and reduce perioperative airway complications, but the comparative evidence from randomised controlled trials has not been systematically evaluated. Methods: This systematic review and meta-analysis will include randomised controlled trials involving children < 18 years with cleft lip and/or palate undergoing general anaesthesia. Eligible studies will compare alternative techniques or devices for airway management or other anaesthetic strategies between two groups of cleft lip/palate patients. The primary outcome will be difficulty in tracheal intubation. Where definitions vary substantially, outcomes will be analysed separately or synthesised narratively. Secondary outcomes will include difficult mask ventilation, oxygen desaturation, airway obstruction, difficult laryngoscopy, first-attempt intubation success, number of intubation attempts, time to successful intubation or airway establishment, failed intubation and other perioperative airway or respiratory adverse events. Two reviewers will independently select RCTs, extract data and assess risk of bias. Risk of bias will be evaluated using the Cochrane Risk of Bias 2 tool. Random-effects meta-analysis will be performed where clinically appropriate. Risk ratios will be used for dichotomous outcomes and mean differences or standardized mean differences for continuous outcomes. Certainty of evidence for important outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Registration and review status: The review was prospectively registered in PROSPERO on 10 March 2026 (CRD420261326076). Full-text screening and data extraction are ongoing and not yet complete. Protocol amendments are documented transparently in PROSPERO.
SN - 1932-6203
ER -