title: Stylet angulation for routine endotracheal intubation with McGrath videolaryngoscope.
abstract: BACKGROUND
  The McGrath videolaryngoscope (VL) provides excellent laryngoscopic views, but directing an endotracheal tube can be difficult, and thus the routine use of a stylet is recommended. The goal of this study is to determine the appropriate angle (60° vs 90°) of the stylet when using the McGrath VL by comparing the time to intubation (TTI).
  
  
  METHODS
  One hundred and forty patients aged 19 to 70 years (American Society of Anesthesiologists classification I or II) who required tracheal intubation for elective surgery were randomly allocated to 1 of 2 groups, at the 60° angle (n = 70) or the 90° angle (n = 70). Anesthesia was induced with propofol, fentanyl, and rocuronium. The primary outcome was TTI assessed by a blind observer. Glottic grade, use of optimal external laryngeal manipulation, failed intubation at first attempt, ease of intubation, and severity of oropharyngeal bleeding were also recorded.
  
  
  RESULTS
  The mean TTI was significantly shorter in the 60° group than in the 90° group (29.3 ± 6.4 vs 32.5 ± 9.4 s, P = 0.022). The glottic grade and degree of intubation difficulty were not significantly different between the 2 groups.
  
  
  CONCLUSIONS
  When intubating the patients with the McGrath videolaryngoscope, the 60° angled stylet allowed for faster orotracheal intubation than did the 90° angled stylet.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, Korea.
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Lee
authors.forename: Jong Yeop
authors.initials: JY
authors.lastname: Kim
authors.forename: Se Yoon
authors.initials: SY
authors.lastname: Kang
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Kwak
authors.forename: Dongchul
authors.initials: D
authors.lastname: Lee
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013997:Time Factors; D014741:Video Recording; D055815:Young Adult