Comparison of the Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation with Topical Anesthesia in Critically Ill Patients
Clinical Medicine Research
Volume 7, Issue 4, July 2018, Pages: 84-91
Received: Jun. 17, 2018;
Accepted: Aug. 29, 2018;
Published: Sep. 28, 2018
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Zhipeng Li, Department of Anesthesiology, Chancheng Center Hospital, Foshan, PR China
Meirong Wang, Department of Anesthesiology, Chancheng Center Hospital, Foshan, PR China
Qiong Wang, Department of Anesthesiology, Chancheng Center Hospital, Foshan, PR China
Chuiliang Liu, Department of Anesthesiology, Chancheng Center Hospital, Foshan, PR China
Background: Emergency airway management outside operating room (OR) is associated with a higher incidence of difficult intubations. The Shikani optical stylet (SOS) has been shown to improve first-attempt success rates compared with the classic Macintosh laryngoscope (ML) in patients with difficult airway inside the operating room (OR). Objective: In this randomized controlled clinical trial, the effectiveness of using a SOS as the primary intubation device was assessed during urgent endotracheal intubations (UEI) in conscious, critically ill patients outside the OR. Method: Sixty conscious critically ill patients from May 2018 to March 2018 were randomly assigned to undergoing intubation guided by the SOS (group S, n = 30) or the Macintosh laryngoscope (group M, n = 30) in ChanCheng Center Hospital,. After application of airway topical anesthesia and intravenous sedatives, endotracheal intubations were performed. The primary measured outcome was first-attempt intubation success rate. Secondary outcomes included ultimate success, the number of attempts, the duration of intubation, and the adverse effects or complications of intubation. Result: The rate of successful intubation at the first-attempt was superior with the SOS as compared with the ML (93.3% vs 63.3%, P = 0.005), the average number of attempts required for successful tracheal intubation (1.0 ± 0.3 vs 1.5 ± 0.8, P = 0.004), the duration of intubation (18.8 ± 11.9 vs 26.8 ± 15.6, P = 0.028), and the incidences of hemorrhage in the oropharyngeal mucosa (0 vs 28.6%, P = 0.006) were all improved significantly with use of the SOS compared with the ML. Conclusion: This study suggested SOS could be used as the effective device when UEIs are performed by experienced operators in conscious, critically ill patients outside the operating room.
Comparison of the Shikani Optical Stylet and Macintosh Laryngoscope for Orotracheal Intubation with Topical Anesthesia in Critically Ill Patients, Clinical Medicine Research.
Vol. 7, No. 4,
2018, pp. 84-91.
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