A comparative evaluation of Video Stylet and flexible fibre-optic bronchoscope in the performance of intubation in adult patients

Abstract

Background and Aims: Video Stylet (VS) is a new intubating modality that provides real-time video of endotracheal intubation (ETI). This device does not need alignment of the oral, pharyngeal and tracheal axes to view glottis and can be used in patients with limited mouth opening. The aim of this study was to compare flexible fibre-optic (FO) bronchoscope with VS in elective surgical patients in apparently normal airway patients requiring oral ETI. Methods: Sixty patients undergoing elective surgery under general anaesthesia of age group 20–60 years, weight 40–70 kg, American Society of Anesthesiologist 1 and 2 and modified Mallampatti I and II were included in the study. Patients in group FO (n = 30) were intubated by flexible FO bronchoscope, whereas patients in group VS (n = 30) were intubated by VS. Primary outcome measure was time taken for intubation (TTI). Secondary outcome measures were successful intubation, haemodynamic response and post-operative complications if any. Results: Average TTI in cases of FO group was 38.2 s (95% confidence interval [CI] 36–41) and in VS group was 19.7 s (95% CI 19–21; P = 0.0001). Three patients required a second attempt for successful intubation in FO group compared to eight in VS group (P = 0.2), with no failures in any group. Haemodynamic response and complications rate were greater in VS group; however, the differences were not statistically significant. Conclusion: VS takes lesser time to intubate than flexible FO bronchoscope.

Keywords

• Airway
• flexible fibre-optic bronchoscope
• intubation time
• Video Stylet