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Objectives: To compare the safety and efficacy of Parker flex-it directional stylet (PFDS) versus conventional malleable stylet (CMS) in orotracheal intubation (OTI) using fiber-optic Macintosh laryngoscope.
Background: OTI is used in general anesthesia for anesthetic delivery and ventilation of patients. OTI delay or failure may adversely affect patient outcomes, therefore, anesthetists with sufficient clinical experience and skill should perform OTI. However, in emergency situations, experienced anesthetists may not be available, and the patient may have a high Cormack-Lehane grade. A stylet is commonly used in the emergency department to aid insertion of the endotracheal tube during direct laryngoscopy.
Patients and Methods: This was a prospective, randomized, double-blind clinical trial; carried out on 80 patients requiring OTI under general anesthesia at our hospital. Patients were randomly allocated into two equal groups; group DS, intubated using PFDS, and group MS, intubated using CMS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group DS (n=40) | Active Comparator | Parker Flex-it Directional Stylet group |
|
| Group MS (n=40) | Active Comparator | Conventional Malleable Stylet group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Parker Flex-it Directional Stylet | Device | Parker Flex-it Directional Stylet |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Mean and Standard deviation of Time required for orotracheal intubation (seconds) (mean±SD) | Time interval from holding the endotracheal tube by the anesthetist till removal of the stylet from the endotracheal tube by the anesthetist | 2 minutes after inserting the blade of the laryngoscope in the mouth |
| Measure | Description | Time Frame |
|---|---|---|
| Mean and Standard deviation of Total time required for orotracheal intubation (seconds) (mean±SD) | Time interval from inserting the blade of the laryngoscope into the patient's mouth till the appearance of end-tidal carbon dioxide curve of at least 30 mmHg on the anesthesia monitor after insertion of the endotracheal tube | 2 minutes after inserting the blade of the laryngoscope in the mouth |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ahmed M Shaat, MD | Damanhour Teaching Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Damanhour Teaching Hospital | Damanhūr | El-Beheira | Egypt |
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| Conventional Malleable Stylet |
| Device |
Conventional Malleable Stylet |
|
| Mean and Standard deviation of Number of intubation attempts (mean±SD) | An attempt is the act of inserting and removing the blade of the laryngoscope from the mouth | 2 minutes after inserting the blade of the laryngoscope in the mouth |
| Number of participants and Rate of Successful intubation from the first-attempt | First-attempt intubation success rate | 2 minutes after inserting the blade of the laryngoscope in the mouth |
| Number of participants and Rate of Use of external laryngeal manipulation | Number of participants and Rate of Use of external laryngeal manipulation | 2 minutes after inserting the blade of the laryngoscope in the mouth |
| Mean and Standard deviation of Heart rate (beat/min.)(mean±SD) | Before, after induction, and 2 minutes after inserting the blade of the laryngoscope in the mouth | 2 minutes after inserting the blade of the laryngoscope in the mouth |
| Mean and Standard deviation of Oxygen Saturation (%)(mean±SD) | Before, after induction, and 2 minutes after inserting the blade of the laryngoscope in the mouth | 2 minutes after inserting the blade of the laryngoscope in the mouth |
| Mean and Standard deviation of Blood Pressure (mmHg)(mean±SD) | Before, after induction, and 2 minutes after inserting the blade of the laryngoscope in the mouth | 2 minutes after inserting the blade of the laryngoscope in the mouth |
| Number of participants and Rate of Procedure-related complications | Number of participants and Rate of: Tachycardia, Dysrhythmia, Hypoxemia, Hypertension, Laryngospasm, Bronchospasm, Oropharyngeal trauma | 5 minutes after the end of the procedure |