Shikani Optical Stylet for Awake Nasal Intubation in Patients Undergoing Head and Neck Surgery

• Published in: The Laryngoscope 2021-02, Vol.131 (2), p.319-325
• Main Authors: Cheng, Tong, Wang, Li‐Kuan, Wu, Hai‐Yin, Yang, Xu‐Dong, Zhang, Xiang, Jiao, Liang
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia, Local; awake nasal intubation; Bronchoscopy; difficult airway; Elective Surgical Procedures; Female; Fiber Optic Technology; fiberoptic intubation; head and neck surgery; Humans; Intubation; Intubation, Intratracheal - instrumentation; Intubation, Intratracheal - methods; Laryngoscopy; Male; Middle Aged; Operative Time; Otorhinolaryngologic Surgical Procedures - instrumentation; Otorhinolaryngologic Surgical Procedures - methods; Prospective Studies; Shikani optical stylet; Surgery; Treatment Outcome; Wakefulness
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.28763

Objectives To evaluate the efficacy and safety of the Shikani optical stylet (SOS) versus fiberoptic bronchoscope (FOB) for awake nasal intubation in head and neck surgery patients with an anticipated difficult airway. Study Design Prospective randomized clinical trial. Methods This study involved 50 adult patients scheduled for elective head and neck surgery and presented with an anticipated difficult airway. Patients planned for awake nasotracheal intubation were randomly divided into two groups: FOB (n = 25) and SOS (n = 25). Patients were intubated under local anesthesia and sedation using the randomly assigned intubation device by anesthetists proficient in both airway devices. The time to successful intubation was regarded as the primary endpoint. Results The median time (interquartile range) to tracheal intubation in the FOB group was 74 seconds (57–108) and 38 seconds (27–60) in the SOS group (P  .999). Airway assisted maneuvers were required in six (24%) SOS intubations compared to 21 (84%) FOB intubations (P