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The GlideScope®-specific rigid stylet and standard malleable stylet are equally effective for GlideScope® use

[Le mandrin rigide spécifique au GlideScope® et le mandrin flexible standard sont tous deux aussi efficaces pour l’utilisation avec le GlideScope®]

From the Department of Anesthesia & Perioperative Medicine, University of Western Ontario, London, Ontario, Canada.

Address correspondence to: Dr. Timothy P. Turkstra, Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre–University Hospital, Room C3-104, 339 Windermere Road, London, Ontario N6A 5A5, Canada. Phone: 519-685-8500; Fax: 519-663-2957; E-mail: timothy.turkstra{at}londonhospitals.ca

Purpose: The GlideScope® videolaryngoscope usually provides excellent glottic visualization, but directing an endotracheal tube (ETT) through the vocal cords can be challenging. The goal of the study was to compare the dedicated GlideScope®-specific rigid stylet to the standard malleable stylet, assessed by time to intubation (TTI).

Methods: Eighty patients requiring orotracheal intubation for elective surgery were randomly allocated to either the GlideScope® rigid stylet (GRS) or a standard malleable stylet to facilitate intubation using the GlideScope®. Time to intubation was recorded by blinded assessors; operators were blinded until after laryngoscopy. The operator assessed the ease of intubation using a visual analogue scale (VAS). The number of intubation attempts, number of failures, glottic grades, and use of external laryngeal manipulation were documented.

Results: The median TTI was 42.7 sec (inter-quartile range (IQR) 38.9–56.7) for the GRS group compared to 39.9 sec (IQR 34.1–48.2) for the control group (P = 0.07). The median VAS score for ease of intubation was 20 (IQR 12.0–33.0) for the GRS group compared to 18 (IQR 9.5–29.5) for the control group (P = 0.21). There was no significant difference in TTI or VAS between stylets. The overall incidence of a Cormack-Lehane grade I or II glottic view was 98%.

Conclusions: In a group of experienced operators using the GlideScope®, the dedicated GRS and the standard malleable ETT stylet are equally effective in facilitating endotracheal intubation.

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