Comparison of Tracheal Intubation Using the Storz's C-Mac D-blade(TM) Video-Laryngoscope Aided by Truflex(TM) Articulating Stylet and the Portex(TM) Intubating Stylet.

BACKGROUND: Tracheal intubation using Storz's C-Mac D-blade(TM) videolaryngoscope is associated with difficult negotiation of the tracheal tube into the glottis due to steep angulation of its blade.

OBJECTIVES: In this study, we hypothesized that Truflex(TM) articulating stylet with its ability to dynamically tailor the ETT shape to patients' oropharyngeal anatomy would be better suited to the D-blade angulation and ease tracheal intubation compared to Portex(TM) intubation stylet.

PATIENTS AND METHODS: Following approval by the Ethical Issues Committee and informed consent, 218 ASA I and II patients of either sex were enrolled in this interventional, single-blind, randomized controlled trial. Tracheal intubation was performed following a uniform general anesthetic technique using the Storz's C-Mac D-blade(TM) videolaryngoscope aided by either Truflex(TM) articulating stylet or the Portex(TM) intubation stylet by an experienced anesthesiologist. The outcome measures included success or failure to intubate in the first attempt, total intubation time, hemodynamic disturbances, trauma if any and user satisfaction.

RESULTS: The number of patients in whom intubation was successful in the first attempt was significantly higher by using Truflex™ articulating stylet (99.1%) compared to Portex(TM) intubation stylet (90.0%; P-Value = 0.003). User satisfaction grade was significantly better while using Truflex(TM) articulating stylet (8.5 ± 0.88) compared to the Portex(TM) intubation stylet (8.23 ± 0.99; P-Value = 0.035). We did not observe any significant difference in total intubation time, hemodynamic disturbances or trauma.

CONCLUSIONS: Storz's C-Mac D-blade(TM) videolaryngoscope provides grade I Cormack and Lehane's glottic view in 99.1% patients. First attempt successful tracheal intubation and user satisfaction significantly improved by Truflex(TM) articulating stylet compared to the Portex(TM) intubation stylet.