The effect of the use of a stylet and/or McGrath videolaryngoscope on intubation time in obese patients: A randomized clinical trial

Abstract

BackgroundObese people have low oxygen reserves because of low functional capacity. For this reason, the time for airway manipulation before intubation is reduced and airway management may be difficult in obese population. AimThe purpose of the present study was to investigate whether videolaryngoscope or stylet or both, shorten the intubation time in obese patients. MethodsA total of 120 obese patients scheduled for surgery under general anesthesia were included in the study, 30 in each group; Group DL utilizing a standardized Macintosh blade, Group DLS: DL utilizing a standardized Macintosh blade + Stylet, Group VL: McGrath VL (Series 5), Group VLS: McGrath VL (Series 5) + Stylet. Intubation time was investigated as the primary outcome. ResultsIntubation times were found to be significantly different between the study groups (P < 0.001). According to the Post-Hoc Test results, the intubation time of Group DL was significantly lower than the intubation time of Group VL and Group VLS (P < 0.001, P = 0.014, respectively). Group DLS intubation time was significantly lower than those of Group VL and Group VLS (P < 0.001, P < 0.001, respectively). Intubation times were similar between the other groups (P > 0.05). ConclusionsThe intubation times of obese patients were shorter with direct laryngoscopy, with or without a stylet when compared to those with a McGrath videolaryngoscope, with or without a stylet. Among the same type of laryngoscopy groups, the use of stylet did not change the intubation time. The rate of first-pass intubation was lower with the stylet-free McGrath videolaryngoscope when compared to direct laryngoscopy and direct laryngoscopy plus stylet groups.