A comparison of the Seeing Optical Stylet and the gum elastic bougie in simulated difficult tracheal intubation: a manikin study

Abstract

Summary Management of the difficult airway is one of the major challenges that anaesthetists face. The flexible fibreoptic scope is widely available but its use requires a level of skill, training and continued practice that is not universally found in all anaesthetists, particularly trainees. The Seeing Optical Stylet is a new, semirigid fibreoptic stylet ‘scope. We compared the Seeing Optical Stylet with a gum elastic bougie in a simulated Cormack and Lehane Grade 3 laryngoscopy in a manikin. Forty‐four anaesthetists were timed while intubating the manikin's trachea with both devices. The mean (SD) time taken with the Seeing Optical Stylet was 20.8 (9.3) s and with the bougie 30 (19.8) s (p = 0.001). Oesophageal intubation occurred six times with the bougie but did not occur with the Seeing Optical Stylet (p = 0.011). We conclude that the Seeing Optical Stylet may be superior to the bougie in difficult tracheal intubation. We feel that the results of this manikin trial are sufficiently encouraging to proceed to a clinical trial in patients.

Comparing the performance of traditional direct laryngoscope with three indirect laryngoscopes: A prospective manikin study in normal and difficult airway scenarios

“…In the difficult airway scenario, some of the participants with TVL and FOS could intubate faster than those with ML. This was consistent with a previous study involving optical stylet and gum elastic bougie 25 …”

Performance of emergency physicians utilizing a video-assisted semi-rigid fiberoptic stylet for intubation of a difficult airway in a high-fidelity simulated patient: a pilot study

“…Among the different difficult airway devices available to EPs, there is a group of devices known as semi-rigid fiberoptic (optical) stylets [3-6]. There have been a number of reported successful intubations with this type of device [3,7-9] in patients with difficult airways and also in a number of simulated difficult airway scenarios [5,10-13]. …”

“…Other studies have compared fiberoptic stylets to other difficult airway techniques and found favorable results in simulated difficult airway models [12,13]. When studied in intubations on live volunteers wearing cervical collars to limit s-spine mobility, a fiberoptic stylet of a slightly different design also had favorable results [9,11].…”

Comparison of the Levitan FPS Scope™ and the single‐use bougie for simulated difficult intubation in anaesthetised patients

“…Although there are case reports and case series documenting efficacy of these devices in management of both routine and difficult airways [3,5,17,[25][26][27][28][29], large comparative studies assessing their efficacy compared with alternative airway devices are lacking. Two studies [30,31] have compared the optical scopes (LFPS and the Shikani optical stylet) with the bougie. These studies were performed with simulated grade III laryngoscopy in manikins with operators having minimal prior experiences with the devices.…”