Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2016.06.001
Brazilian Journal of Anesthesiology
Scientific Article

Comparison of different stylets used for intubation with the C-MAC D-Blade® Videolaryngoscope: a randomized controlled study

Comparação de diferentes estiletes usados para intubação com o videolaringoscópio C-MAC D-Blade®: um estudo randômico e controlado

Dilek Ömür; Baş; ak Bayram; Ş; ule Özbilgin; Volkan Hancı; ; Bahar Kuvaki

http://dx.doi.org/10.1016/j.bjane.2016.06.001 Braz J Anesthesiol, vol.67, n5, p.450-456, 2017
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Abstract

Abstract Objective The angle of the C-MAC D-Blade® videolaryngoscope, which is used for difficult airway interventions, is not compatible with routinely used endotracheal tubes. Methods A prospective randomized crossover study was performed comparing five intubation methods for use with standardized airways, including using different stylets or no stylet: Group HS, hockey-stick stylet; Group DS, D-blade type stylet; Group CS, CoPilot® videolaryngoscope rigid stylet®; Group GEB, gum elastic bougie; and Group NS, no stylet. A manikin was used to simulate difficult intubation with a Storz C-MAC D-Blade® videolaryngoscope. The duration of each intubation stage was evaluated. Results Participants in this study (33 anesthesiology residents and 20 anesthesiology experts) completed a total of 265 intubations. The number of attempts made using no stylet was significantly greater than those made for the other groups (p < 0.05 for group NS- group GEB, group NS- group DS, group NS- group CS and group NS- group HS). The duration to pass the vocal cords significantly differed among all groups (p < 0.001). The total intubation duration was shortest when using D-blade stylet, CoPilot stylet and hockey stick stylet. Although no difference was observed between stylet groups, a significant difference was found between each of these three and no stylet and gum elastic bougie (p < 0.05 and p < 0.001, respectively). Conclusion Use of the correct stylet leads to a more efficient use of the Storz C-MAC D-Blade®. In our study, the use of the D-blade stylet, the CoPilot stylet and the hockey stick stylet provided quicker intubation, allowed easier passage of the vocal cords, and decreased the total intubation duration. To confirm the findings of our study, randomized controlled human studies are needed.

Keywords

C-MAC D-Blade® videolaryngoscopy, Intubation, Stylet, Manikin

Resumo

Resumo Objetivo O ângulo do videolaringoscópio C-D-MAC Blade®, usado para intervenções em via aérea difícil, não é compatível com os tubos endotraqueais rotineiramente usados. Métodos Um estudo prospectivo, randômico e cruzado foi conduzido para comparar cinco métodos de intubação em modelo de via aérea, com o uso de diferentes estiletes em cinco grupos: taco de Hockey; D-blade; CoPilot VL® rígido; Gum Elastic Bougie e controle (sem estilete). Um manequim foi utilizado para simular intubação difícil com o laringoscópio Storz C-MAC D-Blade®. Foi avaliada a duração de cada fase de intubação. Resultados Os participantes deste estudo (33 residentes de anestesiologia e 20 especialistas em anestesiologia) concluíram 265 intubações no total. O número de tentativas realizadas sem estilete foi significativamente maior que o dos outros grupos (p < 0,05 para SE-GEB, SE-DB, SE-CP e SE-HS). O tempo para passar pelas cordas vocais foi significativamente diferente entre todos os grupos (p < 0,001). O tempo total de intubação foi menor com o uso de D-blade, CoPilot VL® rígido e taco de Hockey. Embora não tenha havido diferença entre D-blade, CoPilot VL® rígido e taco de Hockey, uma diferença significativa foi observada entre cada um desses três e os grupos sem estilete e Gum Elastic Bougie (p < 0,05 e p < 0,001, respectivamente). Conclusão A escolha do estilete certo leva ao uso mais eficiente do videolaringoscópio Storz C-MAC D-Blade®. Em nosso estudo, o uso do D-blade, CoPilot VL® rígido e taco de Hockey proporcionou intubação mais rápida, facilitou a passagem pelas cordas vocais e diminuiu o tempo total de intubação. Para confirmar os resultados de nosso estudo, estudos controlados e randômicos com humanos são necessários.

Palavras-chave

Videolaringoscópio C-MAC D-Blade®, Intubação, Estilete, Manequim

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