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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Background Various types of intubation stylets are used to facilitate tracheal intubation because orotracheal intubation (OTI) delay or failure can adversely affect patient outcomes. Objectives To compare the efficacy and safety of Parker Flex-It directional stylet (PFS) versus conventional malleable stylet (CMS) in OTI with the fiberoptic Macintosh laryngoscope. Patients and methods This was a randomized clinical trial that was carried out on 80 patients requiring general anesthesia with OTI for elective noncardiac surgery at Damanhour Teaching Hospital, El-Beheira, Egypt, between May 2021 and March 2022. Patients were randomly allocated into two equal groups: group P, intubated using PFS, and group M, intubated using CMS. Results Time required for OTI and total OTI duration were significantly shorter in group M (13.00 ± 2.801 and 22.25 ± 2.677 s, respectively) than in group P (15.60 ± 2.836 and 25.23 ± 3.034 s, respectively), P value less than 0.001. Endotracheal tube insertion was significantly easier in group M (72.5%) than in group P (45%), with P value of 0.028. Modified Cormack-Lehane grade, external laryngeal manipulations, intubation attempts, and first-attempt success rate were comparable between both groups. Heart rate and noninvasive blood pressure were significantly increased in group P than in group M, and the incidence of tachycardia was significantly higher in group P (22.5%) than in group M (5%), with P value of 0.023. Hypertension and oropharyngeal trauma occurred in both groups, with no statistically significant differences. Conclusion CMS is more effective and safer than PFS in the direct laryngoscopic OTI. It was associated with faster OTI, easier endotracheal tube insertion, and fewer complications rates.

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