OBJECTIVE: To compare the topical anesthesia effects of lidocaine

oxybuprocaine and tetracaine in electronic laryngoscopy. METHODS: Pub Med

Embase

the Cochrane Library

CNKI and Wanfang database were retrieved to extract the randomized clinical trials of the topical anesthesia effects of lidocaine or oxybuprocaine and 1% tetracaine in the electronic laryngoscopy. The retrieval time was from the establishment of the database to Dec. 2020. Two researchers independently screened the literature according to the inclusion and exclusion criteria

and evaluated the methodological quality of included studies. Meta-analysis was performed by using Rev Man 5. 3 software. RESULTS: Thirteen articles were collected

including 4303 patients. Meta-analysis results showed that the significant effective rate and total effective rate of 2% lidocaine ultrasonic atomization topical anesthesia were significantly better than 1% tetracaine spray（ significant effective rate: RR =1. 37

95% CI =1. 28-1. 46

P <0. 000 01; total effective rate: RR = 1. 09

95% CI = 1. 06-1. 13

P < 0. 000 01）

the differences were statistically significant. The significant effective rate and total effective rate of 2% lidocaine ultrasonic atomization topical anesthesia were similar to 1% tetracaine ultrasonic atomization（ significant effective rate: RR = 1. 00

95% CI = 0. 96-1. 03

P = 0. 94; total effective rate: RR =1. 00

95% CI =0. 98-1. 02

P =0. 76）

the difference was not statistically significant. The significant effective rate of topical anesthesia with 0. 4% oxybuprocaine eye drops was better than that with 1% tetracaine（ RR = 1. 23

95% CI =0. 87-1. 73

P =0. 25）. The significant effective rate of topical anesthesia with oxybuprocaine gel was better than 1% tetracaine（ RR =1. 16

95%CI =1. 00-1. 34

P =0. 05）. The total effective rates of topical anesthesia in 0. 4% oxybuprocaine eye drops and oxybuprocaine gel were similar to that of 1% tetracaine（ 0. 4% oxybuprocaine eye drops: RR = 1. 01

95% CI = 0. 99-1. 04

P =0. 32; oxybuprocaine gel: RR =1. 06

95% CI =0. 88-1. 27

P =0. 53）

with no statistically significant difference. The incidence of adverse drug reactions of obucaine gel was significantly lower than that of 1% tetracaine

and the difference was statistically significant（ RR =0. 10

95% CI =0. 01-0. 77

P =0. 03）. CONCLUSIONS: The significant effective rate and total effective rate of2% lidocaine ultrasonic atomization

0. 4% oxybuprocaine eye drops and oxybuprocaine gel are slightly superior or equivalent to1% tetracaine in topical anesthesia effects of the electronic laryngoscopy. In addition

oxybuprocaine gel is safer than 1%tetracaine in topical anesthesia.