Comparison of the GlideRite to the Conventional-malleable-stylet for Endotracheal Intubation by the Macintosh-laryngoscope: A Simulation Study Using Manekins

Abstract

Purpose: The purpose of this study is to compare the effectiveness of the GlideRite with the conventional-malleable- stylet (CMS) in endotracheal intubation (ETI) using the Macintosh-laryngoscope. Methods: This study is a randomized crossover simulation study. Participants performed ETI using both the GlideRite and the CMS in the normal airway and in a tongue edema (simulated difficult airway resulting in lower percentage of glottis opening [POGO]) model. Results: In both the normal and the tongue edema models, all 36 participants performed ETI successfully using the two stylets on the first attempt. In the normal airway model, there was no difference in time required for ETI (TETI) or ease of handling between the two stylets. In the tongue edema model, the TETI increased as POGO score decreased with the CMS (POGO score showing negative correlation with TETI for the CMS, Spearman’s rho=-0.518, p=0.001) but not for the GlideRite (rho=-0.208, p=0.224). The TETI was shorter with the GlideRite than the CMS, but without statistical significance (15.1 vs. 18.8 seconds, p=0.385). Ease of handling was superior with the GlideRite compared to the CMS (p=0.006). Conclusion: Performance of the GlideRite and the CMS was not different in the normal airway model. However, in the simulated difficult airway model with a low POGO score, the GlideRite performed better than the CMS for direct laryngoscopic intubation.