• Ji-Hyun Lee, Sung-Ae Cho, Hyun-Woo Choe, Sang-Hwan Ji, Young-Eun Jang, Eun-Hee Kim, Jin-Tae Kim, and Hee-Soo Kim.
• Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
• Paediatr Anaesth. 2021 Jul 1; 31 (7): 802-808.

BackgroundAn optimal endotracheal tube curve can be a key factor in successful intubation using the GlideScope videolaryngoscope.AimsThis study aimed to evaluate the effects of tube tip-modified stylet curve on the intubation time in children.MethodsChildren aged 1-5 years were randomly assigned to either the standard curve (group S, n = 60) or tip-modified curve (group T, n = 60) groups. In group S, the endotracheal tube curve was similar to that in the GlideScope. In group T, a point approximately 1.5 cm from the tube tip was additionally angled to the left by 15°-20°. The primary outcome was the total intubation time, and the secondary outcomes were incidence of successful intubation in the first attempt, number of additional manipulations of the stylet curve, and visual analog scale (VAS) score for the easiness of intubation.ResultsThe mean total intubation time was significantly longer in group S than that in group T (13.9 [10.8] vs. 9.0 [3.4] sec, mean difference, 4.9 s; 95% confidence interval [CI], 2.0-7.8; p = .001). All patients in group T were successfully intubated in the first attempt, whereas those in group S were not (100% vs. 93.3%, relative risk [RR], 0.11; 95% CI, 0.01-2.02; p = .1376). Three patients in group S could be intubated after modifying the ETT curve similar to that in group T. Operators reported that tracheal intubation was easier in group T than in group S (median [interquartile range] for VAS; 1 [1-2] vs. 2 [1-3]; p < .001).ConclusionsHaving additional angle of the endotracheal tube tip to the left could be a useful technique to facilitate directing and advancing endotracheal tube into the vocal cords.© 2021 John Wiley & Sons Ltd.

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