Intubating conditions with articulating vs. Intubating stylet during video laryngoscope intubation in anticipated difficult airway patients

Ozkan D., Baran I., Sayin M. M., Nalbant B., Ergil J., Donmez A.

Kuwait Medical Journal, vol.53, no.2, pp.184-190, 2021 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 53 Issue: 2
  • Publication Date: 2021
  • Journal Name: Kuwait Medical Journal
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Page Numbers: pp.184-190
  • Keywords: articulating stylet, difficult airway, tracheal intubation, videolaryngoscope
  • Ankara Yıldırım Beyazıt University Affiliated: No


© 2021, Kuwait Medical Association. All rights reserved.Objective: To evaluate the intubation conditions and length of intubation duration of a conventional stylet and an articulating stylet during video laryngoscopy in anticipated difficult intubations Design: A prospective randomized comparative study Setting: University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey Subjects: Forty-nine patients aged 18-65 years assigned for elective surgery with anticipated difficult intubation were randomized to intubation with either an articulating stylet (Group AS, n=25) or intubating stylet (Group IS, n=24) during videolaryngoscopy. Interventions: Standard anesthesia induction was performed and muscle relaxation was facilitated with rocuronuim 0.6 mg/kg after assessment of mask ventilation. In all patients, the same video laryngoscope and angulated blade was used. Anticipated difficult airway scores, thyromental distances (cm), maximum mouth opening, existence of buckteeth, cervical spine range of motion, Mallampati scores, time to intubation (TTI) and number of attempts were recorded. Mean arterial pressure, heart rate and oxygen saturation were recorded before anesthesia induction (T0), one minute after induction (T1), before attempt of intubation (T2) and one minute after intubation (T3). Main outcome measures: Success rate and duration of intubation during videolaryngoscopy Results: The mean TTI was significantly shorter in the AS group than in the IS group (51.8±26.2 s vs 112.8±84.7 s) (P=.001). Successful intubation performance (percent) in the first attempt was 60% in AS group and 16% in IS group (P=.032). Conclusion: During intubation with highly angulated videolaryngoscopes in patients with anticipated difficult intubation, the use of articulating stylets which provide this angulation simultaneously might facililate intubation.