COMPARISON OF THE EFFICACY AND SAFETY OF EACH OF LEVITAN AND SHIKANI OPTICAL STYLETS EITHER USED ALONE OR WITH DIRECT LARYNGOSCOPY FOR TRACHEAL INTUBATION

Abstract

Background: New intubating optical stylets that facilitate visualization have been developed to overcome obstacles faced with management of the difficult airway.
Objective: The aim of the study was a comparison of the efficacy and safety of each of Levitan and Shikani optical stylets either used alone or with direct laryngoscopy for tracheal intubation.
Methods: This study was carried out on two hundred ASA physical status I & II of both sex adult patients who were scheduled for elective surgery under general anesthesia with tracheal intubation. Patients were randomly classified according the used aid for endotracheal intubation into four equal groups (each one consisted of fifty patients). In group I (L/A), Levitan optical stylet was used alone for tracheal intubation with manual chin lift and in group II (L/L), Levitan optical stylet was used with a Macintosh laryngoscope aid to retract the base of the tongue. In group III (S/A), Shikani optical stylet was used alone and in group IV (S/L), Shikani optical stylet was used with the aid of Macintosh laryngoscope. Intubation success rate, intubation time and intubation related complications were recorded in each group.
Results: Statistically, the patients of the four groups were similar in demographic data (age, sex, weight, height, mallampati grade, thyromental distance and interincisor gap). The overall intubation success rates of the four groups were statistically similar. The intubation time and the degree of difficulty in group I (L/A) were significantly lesser than in group III (S/A) and in group II (L/L) were significantly lesser than in group IV (S/L). Also the intubation time and the degree of difficulty in group II (L/L) were significantly lesser than in group I (L/A) and in group IV (S/L) were significantly lesser than in group III (S/A) (Table – 2).The incidence of the various intubation related complications are statistically similar in the four groups.
In conclusion: Levitan optical stylet with or without the aid of direct laryngoscopy is more effective than Shikani optical stylet with or without the aid of direct laryngoscopy for tracheal intubation with similar incidence of intubation related complications.
Key words: Levitan, Shikani, optical, stylet, intubation.