GlideRite® Rigid Stylet Versus Parker Flex-It Stylet
Condition: Anesthesia
Study type: Interventional

Summary: 
      This prospective randomized trial evaluated Parker Flex-It stylet as an alternative to
      manufacturer, s GlideRite® Rigid Stylet to aid intubation with the GlideScope in patients
      undergoing elective non-cardiac surgery that required general anesthesia with orotracheal
      intubation.
    

Detailed description: 
      The GlideScope® Ranger (GVL; Verathon Medical Inc., Bothell, WA, USA) is a novel portable,
      reusable video laryngoscope that has provided superior laryngeal visualization to facilitate
      tracheal intubation especially in the management of difficult airways; it provides indirect
      visualization of the glottis with a pronounced angle of 60° in the blade. It has separate
      monitor connected to the handle via a cable. The tip of the blade is equipped with
      high-resolution digital video camera, an LED light and an antifogging system.

      Unlike the Macintosh laryngoscope, an indirect laryngoscope such as the GlideScope device
      provides a view of the glottis without the need to align the oral pharyngeal and laryngeal
      axes facilitating an excellent glottic visualization. However, insertion and advancement of
      the endotracheal tube (ETT) may be more difficult to pass through the vocal cords than direct
      laryngoscopy, and trauma is possible.

      The GlideScope have shown to function better when used in conjunction with use of a stylet to
      guide insertion of endotracheal tube. The GlideRite Rigid Stylet (GRS) is a reusable rigid
      steel stylet, specifically designed by the manufacturer to resemble the distal part of the
      GVL blade for clear view of the airway, enabling quick intubation , its curvature approaches
      90° with a radius of curvature of approximately 6 cm.

      Various investigators have recommended different curvatures of the ETT/stylet to optimally
      direct it into the trachea, including matching the blade's 60° angle, configuring the ETT
      with a 90° bend, or using a J-shaped ETT. Other potential strategies may include the use of a
      flexible stylet that allows active modification of the tip of the tracheal tube during use.

      The Parker Flex-It Directional Stylet (FIS, Parker Medical, Highlands Ranch, CO) is a 2-piece
      plastic stylet, can be used for oral intubation, and allows continuous adjustment of the tube
      curvature during an intubation to enable the tube to follow the curvature of the airway. We
      hypothesized that the use of Parker Flex-It stylet to guide ETT might offer some benefit over
      the GRS.

      Therefore, the purpose of this study was to determine the optimal stylet-tracheal tube
      strategy for use with the GlideScope® laryngoscope. We compared efficacy of the two
      intubating aids including GlideRite® Rigid Stylet versus Parker Flex-It stylet for
      orotracheal intubation in terms of the total intubation time (primary outcome), ease of
      intubation, the number of intubation attempts , the number of optimization man oeuvres and
      possible trauma (secondary outcomes) when used by experienced GlideScope operators.
    

Intervention name(s): Glide Rite Rigid Stylet group; Parker Flex-It directional stylet group
Intervention type(s): Device; Device
Intervention description(s): Intubation with the GlideScope® video-laryngoscope and styletted the tracheal tube using manufacturer's GlideRite Rigid Stylet (GRS) (GVL - ST1; Verathon Medical Inc., Bothell, WA, USA). Time till successful intubation of the patient is calculated.; Intubated with the GlideScope® video-laryngoscope and styletted the tracheal tube using Parker-Flex-It directional Stylet (Parker Medical, Colorado, USA) (Flexi-Stylet). Time till successful intubation of the patient is calculated.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: GlideRite; Stylet; Parker; orotracheal; intubation; GlideScope