The StyletScope™ is a better intubation tool than a conventional stylet during simulated cervical spine immobilization

Kihara, Shinichi, Yaguchi, Yuichi, Taguchi, Noriko, Brimacombe, Joseph R., and Watanabe, Seiji (2005) The StyletScope™ is a better intubation tool than a conventional stylet during simulated cervical spine immobilization. Canadian Journal of Anaesthesia, 52 (1). pp. 105-110.

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Abstract

Purpose: We compare the StyletScope™ fibreoptic stylet (FOS) and the Satin Slip™ conventional metal stylet (CMS), during simulated difficult airway management with manual-in-line stabilization in terms of ease of intubation and esophageal intubation.

Methods: 193 patients (ASA I–II, 18–80 yr) were studied in a non crossover, randomized fashion. Manual-in-line stabilization was applied and the best laryngoscopic view obtained. For the CMS, the primed tracheal tube was advanced under direct vision if Cormack-Lehane grade 1/2, placed behind the epiglottis and advanced blindly if grade 3, and intubation was not attempted if grade 4. For the FOS, the primed tracheal tube was advanced under the direct vision if grade 1/2 and under fibre optic vision if grade 3/4.

Results: Intubation was successful more frequently (P = 0.02) and required fewer attempts (P = 0.003) with the FOS than the CMS. Intubation with the FOS was successful more frequently (P = 0.02) and required fewer attempts (P = 0.007) than the CMS if grade 3/4. For both stylets, intubation required fewer attempts (P < 0.007) and was quicker (P # 0.0001) for grade 1/2 than 3/4. Esophageal intubation occurred more frequently with the CMS (14 vs 0, P = 0.0001).

Conclusion: Tracheal intubation is more successful, requires fewer attempts and esophageal intubation is less frequent with the FOS than the CMS during cervical spine immobilization using manual-inline axial stabilization. The FOS is a more effective intubation instrument compared to the CMS in patients with simulated cervical spine immobilization.

Item ID: 6053
Item Type: Article (Research - C1)
ISSN: 1496-8975
Keywords: air flow; anesthesiology; intubation
Date Deposited: 15 Jan 2010 05:40
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
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