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Shikani Optical Stylet for Awake Nasal Intubation in Patients Undergoing Head and Neck Surgery
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 5...
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| Published in: | The Laryngoscope 2021-02, Vol.131 (2), p.319-325 |
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| Main Authors: | , , , , , |
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| container_end_page | 325 |
| container_issue | 2 |
| container_start_page | 319 |
| container_title | The Laryngoscope |
| container_volume | 131 |
| creator | Cheng, Tong Wang, Li‐Kuan Wu, Hai‐Yin Yang, Xu‐Dong Zhang, Xiang Jiao, Liang |
| description | 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 |
| doi_str_mv | 10.1002/lary.28763 |
| format | article |
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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 < .001). Intubation success rates on the first attempt in the FOB and SOS groups were 96% and 92%, respectively (P > .999). Airway assisted maneuvers were required in six (24%) SOS intubations compared to 21 (84%) FOB intubations (P < .001). There were no significant differences between the groups in the incidences of oxygen desaturation and postoperative complications related to intubation.
Conclusion
Compared to the FOB group, awake nasal intubation in the SOS group required significantly less time and fewer airway‐assisted maneuvers on adult head and neck surgery patients with anticipated difficult airway.
Level of Evidence
2 Laryngoscope, 131:319–325, 2021</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.28763</identifier><identifier>PMID: 32521054</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>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</subject><ispartof>The Laryngoscope, 2021-02, Vol.131 (2), p.319-325</ispartof><rights>2020 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2021 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3573-dd74fd66f2921500af0c1140d22bb24b6536d4cb33f1ef298f3fbdb828d36ced3</citedby><cites>FETCH-LOGICAL-c3573-dd74fd66f2921500af0c1140d22bb24b6536d4cb33f1ef298f3fbdb828d36ced3</cites><orcidid>0000-0002-8019-2641</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32521054$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheng, Tong</creatorcontrib><creatorcontrib>Wang, Li‐Kuan</creatorcontrib><creatorcontrib>Wu, Hai‐Yin</creatorcontrib><creatorcontrib>Yang, Xu‐Dong</creatorcontrib><creatorcontrib>Zhang, Xiang</creatorcontrib><creatorcontrib>Jiao, Liang</creatorcontrib><title>Shikani Optical Stylet for Awake Nasal Intubation in Patients Undergoing Head and Neck Surgery</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>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 < .001). Intubation success rates on the first attempt in the FOB and SOS groups were 96% and 92%, respectively (P > .999). Airway assisted maneuvers were required in six (24%) SOS intubations compared to 21 (84%) FOB intubations (P < .001). There were no significant differences between the groups in the incidences of oxygen desaturation and postoperative complications related to intubation.
Conclusion
Compared to the FOB group, awake nasal intubation in the SOS group required significantly less time and fewer airway‐assisted maneuvers on adult head and neck surgery patients with anticipated difficult airway.
Level of Evidence
2 Laryngoscope, 131:319–325, 2021</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia, Local</subject><subject>awake nasal intubation</subject><subject>Bronchoscopy</subject><subject>difficult airway</subject><subject>Elective Surgical Procedures</subject><subject>Female</subject><subject>Fiber Optic Technology</subject><subject>fiberoptic intubation</subject><subject>head and neck surgery</subject><subject>Humans</subject><subject>Intubation</subject><subject>Intubation, Intratracheal - instrumentation</subject><subject>Intubation, Intratracheal - methods</subject><subject>Laryngoscopy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Otorhinolaryngologic Surgical Procedures - instrumentation</subject><subject>Otorhinolaryngologic Surgical Procedures - methods</subject><subject>Prospective Studies</subject><subject>Shikani optical stylet</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Wakefulness</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp90E9LwzAYBvAgipvTix9AAl5E6Myfpu2OY6gbjE2cA71Y0iaZ2bp0Ji2j397MTQ8ePOUl74-HlweAS4y6GCFyV3DbdEkSR_QItDGjOAh7PXYM2n5Jg4SR1xY4c26JEI4pQ6egRQkjGLGwDd5nH3rFjYbTTaVzXsBZ1RSygqq0sL_lKwkn3PnvkanqjFe6NFAb-OQnaSoH50ZIuyi1WcCh5AJyI-BE5is4q-1C2uYcnCheOHlxeDtg_nD_MhgG4-njaNAfBzllMQ2EiEMlokiRHsEMIa5QjnGIBCFZRsIsYjQSYZ5RqrD0KFFUZSJLSCJolEtBO-Bmn7ux5WctXZWutctlUXAjy9qlJMSEEBzHoafXf-iyrK3x13kVR0lCe5R4dbtXuS2ds1KlG6vXvugUo3TXerprPf1u3eOrQ2SdraX4pT81e4D3YKsL2fwTlY77z2_70C9AFIxI</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Cheng, Tong</creator><creator>Wang, Li‐Kuan</creator><creator>Wu, Hai‐Yin</creator><creator>Yang, Xu‐Dong</creator><creator>Zhang, Xiang</creator><creator>Jiao, Liang</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8019-2641</orcidid></search><sort><creationdate>202102</creationdate><title>Shikani Optical Stylet for Awake Nasal Intubation in Patients Undergoing Head and Neck Surgery</title><author>Cheng, Tong ; Wang, Li‐Kuan ; Wu, Hai‐Yin ; Yang, Xu‐Dong ; Zhang, Xiang ; Jiao, Liang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3573-dd74fd66f2921500af0c1140d22bb24b6536d4cb33f1ef298f3fbdb828d36ced3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia, Local</topic><topic>awake nasal intubation</topic><topic>Bronchoscopy</topic><topic>difficult airway</topic><topic>Elective Surgical Procedures</topic><topic>Female</topic><topic>Fiber Optic Technology</topic><topic>fiberoptic intubation</topic><topic>head and neck surgery</topic><topic>Humans</topic><topic>Intubation</topic><topic>Intubation, Intratracheal - instrumentation</topic><topic>Intubation, Intratracheal - methods</topic><topic>Laryngoscopy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Otorhinolaryngologic Surgical Procedures - instrumentation</topic><topic>Otorhinolaryngologic Surgical Procedures - methods</topic><topic>Prospective Studies</topic><topic>Shikani optical stylet</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Wakefulness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, Tong</creatorcontrib><creatorcontrib>Wang, Li‐Kuan</creatorcontrib><creatorcontrib>Wu, Hai‐Yin</creatorcontrib><creatorcontrib>Yang, Xu‐Dong</creatorcontrib><creatorcontrib>Zhang, Xiang</creatorcontrib><creatorcontrib>Jiao, Liang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, Tong</au><au>Wang, Li‐Kuan</au><au>Wu, Hai‐Yin</au><au>Yang, Xu‐Dong</au><au>Zhang, Xiang</au><au>Jiao, Liang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Shikani Optical Stylet for Awake Nasal Intubation in Patients Undergoing Head and Neck Surgery</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2021-02</date><risdate>2021</risdate><volume>131</volume><issue>2</issue><spage>319</spage><epage>325</epage><pages>319-325</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>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 < .001). Intubation success rates on the first attempt in the FOB and SOS groups were 96% and 92%, respectively (P > .999). Airway assisted maneuvers were required in six (24%) SOS intubations compared to 21 (84%) FOB intubations (P < .001). There were no significant differences between the groups in the incidences of oxygen desaturation and postoperative complications related to intubation.
Conclusion
Compared to the FOB group, awake nasal intubation in the SOS group required significantly less time and fewer airway‐assisted maneuvers on adult head and neck surgery patients with anticipated difficult airway.
Level of Evidence
2 Laryngoscope, 131:319–325, 2021</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>32521054</pmid><doi>10.1002/lary.28763</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8019-2641</orcidid></addata></record> |
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| 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 |
| title | Shikani Optical Stylet for Awake Nasal Intubation in Patients Undergoing Head and Neck Surgery |
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