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The Flex-It stylet is less effective than a malleable stylet for orotracheal intubation using the GlideScope.
Anesth Analg. 2009 Dec; 109(6):1856-9.A&A

Abstract

BACKGROUND

The GlideScope videolaryngoscope (Verathon Medical, Bothell, WA) usually provides excellent glottic visualization, but directing an endotracheal tube through the vocal cords can be challenging. The goal of the study was to compare the dedicated Flex-It stylet (FIS, Parker Medical, Highlands Ranch, CO) with a malleable stylet, as assessed by time to intubation (TTI).

METHODS

Eighty patients requiring orotracheal intubation for elective surgery were randomly allocated to either the FIS or a malleable stylet (control) to facilitate tracheal intubation using the GlideScope. TTI was recorded by blinded assessors; operators were blinded until after laryngoscopy. The operator assessed the ease of intubation using a 100-mm visual analog scale (0 = easy to 100 = difficult). The number of intubation attempts, number of failures, glottic grades, and use of external laryngeal manipulation were documented.

RESULTS

The median TTI was 41 s (interquartile range [IQR] 30-51) for the Flex-It group compared with 32 s (IQR 28-42) for the control group (P = 0.03). The median visual analog scale score for ease of intubation was 20 (IQR 11-39) for the Flex-It group compared with 15 (IQR 8-28) for the control group (P = 0.13). The overall incidence of a Cormack-Lehane Grade I or II glottic view was 100%.

CONCLUSIONS

In a group of experienced operators using the GlideScope, the FIS was less effective for orotracheal intubation than a malleable endotracheal tube stylet.

Authors+Show Affiliations

Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, University Hospital, Room C3-104, 339 Windermere Rd., London, Ontario, Canada N6A 5A5. timothy.turkstra@londonhospitals.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19923515

Citation

Turkstra, Timothy P., et al. "The Flex-It Stylet Is Less Effective Than a Malleable Stylet for Orotracheal Intubation Using the GlideScope." Anesthesia and Analgesia, vol. 109, no. 6, 2009, pp. 1856-9.
Turkstra TP, Jones PM, Ower KM, et al. The Flex-It stylet is less effective than a malleable stylet for orotracheal intubation using the GlideScope. Anesth Analg. 2009;109(6):1856-9.
Turkstra, T. P., Jones, P. M., Ower, K. M., & Gros, M. L. (2009). The Flex-It stylet is less effective than a malleable stylet for orotracheal intubation using the GlideScope. Anesthesia and Analgesia, 109(6), 1856-9. https://doi.org/10.1213/ANE.0b013e3181bc116a
Turkstra TP, et al. The Flex-It Stylet Is Less Effective Than a Malleable Stylet for Orotracheal Intubation Using the GlideScope. Anesth Analg. 2009;109(6):1856-9. PubMed PMID: 19923515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Flex-It stylet is less effective than a malleable stylet for orotracheal intubation using the GlideScope. AU - Turkstra,Timothy P, AU - Jones,Philip M, AU - Ower,Katherine M, AU - Gros,Michelle L, PY - 2009/11/20/entrez PY - 2009/11/20/pubmed PY - 2009/12/16/medline SP - 1856 EP - 9 JF - Anesthesia and analgesia JO - Anesth. Analg. VL - 109 IS - 6 N2 - BACKGROUND: The GlideScope videolaryngoscope (Verathon Medical, Bothell, WA) usually provides excellent glottic visualization, but directing an endotracheal tube through the vocal cords can be challenging. The goal of the study was to compare the dedicated Flex-It stylet (FIS, Parker Medical, Highlands Ranch, CO) with a malleable stylet, as assessed by time to intubation (TTI). METHODS: Eighty patients requiring orotracheal intubation for elective surgery were randomly allocated to either the FIS or a malleable stylet (control) to facilitate tracheal intubation using the GlideScope. TTI was recorded by blinded assessors; operators were blinded until after laryngoscopy. The operator assessed the ease of intubation using a 100-mm visual analog scale (0 = easy to 100 = difficult). The number of intubation attempts, number of failures, glottic grades, and use of external laryngeal manipulation were documented. RESULTS: The median TTI was 41 s (interquartile range [IQR] 30-51) for the Flex-It group compared with 32 s (IQR 28-42) for the control group (P = 0.03). The median visual analog scale score for ease of intubation was 20 (IQR 11-39) for the Flex-It group compared with 15 (IQR 8-28) for the control group (P = 0.13). The overall incidence of a Cormack-Lehane Grade I or II glottic view was 100%. CONCLUSIONS: In a group of experienced operators using the GlideScope, the FIS was less effective for orotracheal intubation than a malleable endotracheal tube stylet. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/19923515/The_Flex_It_stylet_is_less_effective_than_a_malleable_stylet_for_orotracheal_intubation_using_the_GlideScope_ L2 - http://dx.doi.org/10.1213/ANE.0b013e3181bc116a DB - PRIME DP - Unbound Medicine ER -