A comparison of the Trachway intubating stylet and the Macintosh laryngoscope in tracheal intubation: a manikin study.
OBJECTIVE
The Trachway intubating stylet (Trachway(®)), when used by experienced anesthesiologists, has been shown to be effective for difficult airway management. We evaluated the efficacy of this intubating stylet for tracheal intubation in a manikin when used by experienced laryngoscopists with little experience using this device.


METHODS
Thirty-eight nurse anesthesiologists intubated the trachea of a manikin (Laerdal Airway Management Trainer) with a Trachway intubating stylet or a Macintosh laryngoscope in easy and difficult laryngoscopy scenarios. The duration of the intubation attempts, success rates, dental trauma, and ease of use (0 = very easy; 10 = very difficult) were recorded. The primary endpoint was the duration of the successful tracheal intubation attempt in the difficult laryngoscopy scenario. Data are presented as means (SD).


RESULTS
Both devices resulted in similar tracheal intubation performance in the easy laryngoscopy scenario. However, the Trachway intubating stylet provided shorter intubation times (20.8 ± 5.6 vs. 25.5 ± 7.3 s; p = 0.003) and easier intubations (2.4 ± 1.6 vs. 5.7 ± 1.8; p < 0.001) compared with the Macintosh laryngoscope in the difficult laryngoscopy scenario. All tracheal intubations were successful and no dental trauma was observed when using the Trachway intubating stylet.


CONCLUSIONS
We concluded that the Trachway intubating stylet, when used by novices, is effective in both easy and difficult laryngoscopy scenarios. In difficult laryngoscopy scenarios, this device provided faster, easier, and less traumatic intubation than the Macintosh laryngoscope.
Department of Anesthesiology, E-DA Hospital, I-Shou University, E-Da Road, Jiau-shu Tsuen, Yan-Chau Shiang, Kaohsiung 824, Taiwan, ROC. ed102605@gmail.com
Kuo-Chuan
KC
Hung
Ping-Heng
PH
Tan
Victor Chia-Hsiang
VC
Lin
Hao-Kuang
HK
Wang
Hung-Shu
HS
Chen
D000328:Adult; D058109:Airway Management; D000776:Anesthesiology / Q000193:education; D002983:Clinical Competence; D023381:Endpoint Determination; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000295:instrumentation*; D008348:Manikins; D009719:Nurse Anesthetists