Alternative management techniques for the difficult airway: Optical stylets

Current Opinion in Anaesthesiology

Volumn 17, Issue 6, 2004, Pages 495-498

  Gravenstein, Dietrich ^a   Liem, Edwin B ^b   Bjoraker, David G ^a  

^a UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE   (United States)

^b University of Louisville School of Medicine   (United States)

Author keywords

Difficult airway; Management; Optical; Stylet

Indexed keywords

AIRWAY; COST; DEVICE; ENDOBRONCHIAL INTUBATION; ENDOTRACHEAL TUBE; FIBEROSCOPE; HUMAN; LARYNGEAL MASK; LITERATURE; PRIORITY JOURNAL; REVIEW;

EID: 10344246142     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001503-200412000-00008     Document Type: Review

References (17)

1. Cooper RM. Use of a new videolaryngoscope (GlideScope®) in the management of a difficult airway. Can J Anesth 2003; 50:611-613.
2. Doyle DJ. Awake intubation using the GlideScope® video laryngoscope: initial experience in four cases [letter]. Can J Anesth 2004; 51:520-521.
3. Kaplan MB, Berci G, Doyle DJ, et al. Videolaryngoscopy in the management of the difficult airway (Letter). Can J Anesth 2004; 51:94-96.
4. Agrò F, Barzoi G, Montecchia F. Tracheal intubation using a Macintosh laryngoscope or a GlideScope® in 15 patients with cervical spine immobilization [letter]. Br J Anaesth 2003; 90:705-706.
5. Agrò F, Carassiti M, Barzoi G, et al. A first report on the diagnosis and treatment of acute postoperative airway obstruction with the CobraPLA™ [letter]. Can J Anesth 2004; 51:640-641.
6. Lim Y, Lim TJ, Liu EHC. Ease of intubation with the GlideScope or Macintosh laryngoscope by inexperienced operators in simulated difficult airways [letter]. Can J Anesth 2004; 51:641-642.
7. Doyle DJ. Miniaturizing the GlideScope® video laryngoscope system: a new design for enhanced portability [letter]. Can J Anesth 2004; 51:642-643.
8. Agrò F, Barzoi G, Gallì B. The CobraPLA™ in 110 anaesthetized and paralyzed patients: what size to choose [letter]. Br J Anaesth 2004; 92:777-778.
9. Akça O, Wadhwa A, Sengupta P, et al. The new perilaryngeal airway (CobraPLA™) is as efficient as the laryngeal mask airway (LMA) but provides better airway sealing pressures. Anesth Analg 2004; 99:272-278.
10. Szmuk P, Matuszcak M, Ghelber O, Rabb MF. Use of CobraPLA™ for management of difficult airway in two infants (Poster). Pediatr Anesth March 4-7, 2004; P42.
11. Vaida SJ, Gaitini D, Ben-David B, et al. A new supraglottic airway, the Elisha Airway Device: a preliminary study. Anesth Analg 2004; 99:124-127.
12. Liem EB, Bjoraker DG, Gravenstein D. New options for airway management: intubating fibreoptic stylets [review]. Br J Anaesth. 2003; 91:408-418. A comprehensive review of the evolution of optical stylets that includes a discussion of all prior literature on the subject. In addition, this review details device design differences and discusses clinical outcome data for each device. Read this before purchasing an optical stylet for your practice.
13. Wong P, Lawrence C, Pearce A, et al. Intubation times for using the Bonfils intubation fibrescope [letter]. Br J Anaesth 2003; 91:757-758. A letter and response detailing a successful intubation rate of only 86% by inexperienced users. Several common factors complicating device performance are discussed.
14. Halligan M, Charters P. Learning curve for the Bonfils intubation fibrescope. Br J Anaesth 2003; 90:826P. Two clinicians performed 30 intubations each and found improved and stable intubation times after gaining experience.
15. Halligan M, Charters P. A clinical evaluation of the Bonfils Intubation Fibrescope. Anaesthesia 2003; 58:1087-1091. This article evaluates the device on its efficacy, time to intubation and complications. A balanced discussion of the difficulties encountered and strategies for reducing these is valuable.
16. Bein B, Worthmann F, Scholz J, et al. A comparison of the intubating laryngeal mask airway and the Bonfils intubation fibrescope in patients with predicted difficult airways. Anaesthesia 2004; 59:668-674. These investigators demonstrate that the intubating laryngeal mask airway provides adequate ventilation faster, but time to intubation is longer than with the Bonfils. For emergent airway support, therefore, the Bonfils will not be the first choice of inexperienced users.
17. Young CF, Rosenblatt WH. A better mousetrap? Evaluation of the user interface, complications, and efficacy of the Shikani Optical Stylet for orotracheal intubation [abstract]. STA 2004 14th Annual Meeting, January 17-24, 2004; Albuquerque/Santa Fe, NM. This brief report does not describe the airways that were encountered but concludes the device is well designed and could be used on a routine basis instead of direct laryngoscopy.