A randomized comparison of the GlideRite((R)) Rigid Stylet to a malleable stylet for orotracheal intubation by novices using the GlideScope((R)).

摘要

PURPOSE: A stylet is usually necessary when using the GlideScope((R)) videolaryngoscope for orotracheal intubation. A special stylet, the GlideRite((R)) Rigid Stylet (GRS), was designed for this purpose. A previous trial involving experienced operators showed that the GRS offered no performance improvement vs a standard malleable stylet (SMS). In our trial, we compared the performance of the GRS with that of the SMS in terms of time to intubation and ease of intubation when used by novice GlideScope((R)) operators. METHODS: Sixty patients with normal-appearing airways requiring orotracheal intubation for elective surgery were randomly allocated to be intubated by novice operators with the GlideScope((R)), using either the GRS or the SMS. Time to intubation was assessed by a blinded observer, and the operators were blinded until just prior to tracheal intubation. Ease of intubation was assessed by a five-point ordinal scale (from 1- easy to 5 -difficult). Intubation attempts/failures, glottic grades, and usage of external laryngeal manipulation were recorded. RESULTS: There were no significant differences between the GRS and the SMS in terms of the median time to intubation (60 sec, interquartile range [IQR] 48-75 vs 61 sec, IQR 49-75, respectively; P = 0.94) and the ease of intubation (GRS median score: 1.5, IQR 1-2 vs SMS median score: 1, IQR 1-2; P = 0.94). There were no other significant differences between groups. CONCLUSION: The GRS and the SMS have similar performance characteristics when used by novice operators for GlideScope((R))-assisted orotracheal intubation. (Registered at ClinicalTrials.gov: NCT00884754).