Comparing S-Guide® and Gliderite® Times to Assist Video laryngoscopic Intubation in Patients with Simulated Difficult Airways: A Single-Blinded Randomized Prospective Study.

Abstract

Objective:Gliderite®, one of the first stylets designed specifically to assist tracheal intubation with non-channeled curved blades video laryngoscopes, can cause injury. The S-Guide® is a new, malleable, intubating guide allowing oxygenation. Its soft tip is designed to prevent trauma. We aimed to compare the duration of tracheal intubation with S-Guide compared to Gliderite using a C-MAC® D-Blade® video laryngoscope in patients with simulated difficult airways. Methods:We performed a single-blinded prospective randomized study, with 50 adult patients requiring orotracheal intubation under general anaestheesia in Lausanne University Hospital. A cervical collar was fitted around the patient’s neck to simulate difficult intubation conditions. Exclusion criteria were American Society of Anesthesiologists (ASA) >3, BMI > 35 kg m2, known or at risk of difficult intubation, and risk of aspiration of gastric content. We recorded T1: time of identification of the glottis; T2: time to inflate the cuff, and T3: total intubation time (capnography curve appearance). Secondary outcomes were the presence of arytenoid contact during intubation and postoperative airway discomfort.Results:There were no significant differences between T1 and T2 (seconds) while using the S-Guide or Gliderite, respectively: 14.6 [9.6-18.6] vs 16.5 [11.0-20.6]; P = .368 and 43.3 [33.2-49.3] vs 46.3 [35.6-61.5], P = .308. T3 was significantly shorter in the S-Guide group: 58.1 [50.2-61.8] vs 65.3 [57.6-78.7], P = .044. Fewer arytenoid contact occurred during intubation using the S-Guide (P = .032), without difference in postoperative airway discomfort.Conclusion:S-Guide-assisted tracheal intubation, with a C-MAC D-Blade in simulated difficult airways, allows successful and faster intubation than with the Gliderite Stylet.