Intubation without use of stylet for McGrath videolaryngoscopy in patients with expected normal airway A randomized noninferiority trial
- Authors
- Kwak, Hyun Jeong; Lee, Sook Young; Lee, Su Youn; Kim, Yong Beom; Kim, Jong Yeop
- Issue Date
- Nov-2016
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- anesthetic technique; laryngoscopy; McGrath videolaryngoscope; stylet
- Citation
- MEDICINE, v.95, no.48
- Journal Title
- MEDICINE
- Volume
- 95
- Number
- 48
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/7748
- DOI
- 10.1097/MD.0000000000005498
- ISSN
- 0025-7974
- Abstract
- Background: During McGrath videolaryngoscope (VL) intubation, a styletted endotracheal tube maintaining an upward distal tip angle is recommended by some manufacturers. However, a styletted endotracheal tube can elicit rare but potentially serious complications. The purpose of this study was to demonstrate that a nonstyletted tube with exaggerated curvature would be noninferior to a styletted tube for orotracheal intubation using McGrath VL in patients with expected normal airway, by comparing the time to intubation and ease of intubation. Methods: One hundred forty patients, ages 19 to 70 years (American Society of Anesthesiologists physical status I-II), undergoing tracheal intubation for elective surgery were randomly allocated to the nonstylet group (n = 70) or the stylet group (n = 70). Anesthesia induction consisted of propofol, remifentanil, and rocuronium. The primary outcome was time to intubation assessed by a blind observer. Cormack and Lehane glottic grade, easy of intubation, and intubation difficulty score (IDS) were also assessed. Results: Median time to intubation [interquartile range] was not different between the nonstylet group and the stylet group (26 [24-32.5] s vs 27 [25-31] s, P = 0.937). There was no significant in median IDS between the nonstylet group and the stylet group (P = 0.695). Conclusion: This study shows that a nonstyletted endotracheal tube with exaggerated curvature has a similar performance to a styletted tube with a hockey-stick curvature during intubation using McGrath VL regarding time taken to successful intubation and easiness of intubation.
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