Ultrasound-guided versus Shikani optical stylet-aided tracheal intubation: a prospective randomized study
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RESEARCH ARTICLE
Open Access
Ultrasound-guided versus Shikani optical stylet-aided tracheal intubation: a prospective randomized study Yuanyuan Ma1, Yan Wang1,2*, Ping Shi1, Xue Cao1 and Shengjin Ge1*
Abstract Background: To compare ultrasound-guided tracheal intubation (UGTI) versus Shikani optical stylet (SOS)-aided tracheal intubation in patients with anticipated normal airway. Methods: Sixty patients aged 18–65 years old who presented for elective surgery under general anesthesia were recruited in this prospective randomized study. They were assigned into two equal groups, either an ultrasoundguided group (Group UG, n = 30) or an SOS-aided group (Group SOS, n = 30). After the induction of anesthesia, the tracheal intubation was performed by a specified skilled anesthesiologist. The number of tracheal intubation attempt and the duration of successful intubation on the first attempt were recorded. Complications relative to tracheal intubation including desaturation, hoarseness and sore throat were also recorded. Results: The first-attempt success rate is 93.3% (28/30) in Group UG and 90% (27/30) in Group SOS (P = 0.640). The second-attempt was all successful for the 2 and 3 patients left in the two groups, and the overall success rate of both groups was 100%. The duration of successful intubation on the first attempt of Group UG was not significantly different from that of Group SOS (34.0 ± 20.8 s vs 35.5 ± 23.2 s, P = 0.784). One patient in Group SOS had desaturation (P = 0.313), and there was none hoarseness in the two groups. Sore throat was detected in both group (4 in Group UG, 5 in Group SOS, P = 0.718). Conclusion: Ultrasound-guided tracheal intubation was as effective as Shikani optical stylet-aided tracheal intubation in adult patients with anticipated normal airway. Trial registration: Chinese Clinical Trial Registry, ChiCTR-IIC-17010875. Date of Registration: 15 March 2017. Keywords: Ultrasound, Shikani optical Stylet, Tracheal intubation, Anesthesia
Background Nowadays, ultrasound is used to manage the airway in anesthesia and intensive care as a non-invasive tool. Real-time surface ultrasound-guided tracheal intubation (UGTI) was firstly reported by Fiadjoe et al. [1] on a 14month-old child. They provided a new perspective of endotracheal intubation: from the outside rather than * Correspondence: [email protected]; [email protected] 1 Department of Anesthesia, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai 200032, China Full list of author information is available at the end of the article
the inside. Optical stylet is also a nonconventional intubation tool, which integrates flexible fiberoptic imaging features in a rigid intubating stylet. The Shikani optical stylet (SOS) (Clarus Medical, Minneapolis, MN) is one of the most commonly used fiberoptic stylets for intubation. It not only has the characteristics of a fiberoptic bronchoscope but also very light and convenient [2, 3]. UGTI and SOS-aided tracheal intubation have some similar manipulations in the intubation: o
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