• Hyun Jeong Kwak, Sook Young Lee, Su Youn Lee, Yong Beom Kim, and Jong Yeop Kim.
• Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea.
• Medicine (Baltimore). 2016 Nov 1; 95 (48): e5498.

BackgroundDuring McGrath videolaryngoscope (VL) intubation, a styletted endotracheal tube maintaining an upward distal tip angle is recommended by some manufacturers. However, a styletted endotracheal tube can elicit rare but potentially serious complications. The purpose of this study was to demonstrate that a nonstyletted tube with exaggerated curvature would be noninferior to a styletted tube for orotracheal intubation using McGrath VL in patients with expected normal airway, by comparing the time to intubation and ease of intubation.MethodsOne hundred forty patients, ages 19 to 70 years (American Society of Anesthesiologists physical status I-II), undergoing tracheal intubation for elective surgery were randomly allocated to the nonstylet group (n = 70) or the stylet group (n = 70). Anesthesia induction consisted of propofol, remifentanil, and rocuronium. The primary outcome was time to intubation assessed by a blind observer. Cormack and Lehane glottic grade, easy of intubation, and intubation difficulty score (IDS) were also assessed.ResultsMedian time to intubation [interquartile range] was not different between the nonstylet group and the stylet group (26 [24-32.5] s vs 27 [25-31] s, P = 0.937). There was no significant in median IDS between the nonstylet group and the stylet group (P = 0.695).ConclusionThis study shows that a nonstyletted endotracheal tube with exaggerated curvature has a similar performance to a styletted tube with a hockey-stick curvature during intubation using McGrath VL regarding time taken to successful intubation and easiness of intubation.

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