S-Guide® : Comparaison du S-Guide avec le Gliderite®, dans l’intubation au vidéolaryngoscope chez des patients aux voies aériennes difficiles simulées

Objective: Gliderite™, one of the first stylets designed specifically to assist tracheal intubation with non-channelled curved blades videolaryngoscopes, can cause injury. The S-Guide® is a new, malleable, intubating guide allowing oxygenation. Its soft tip is designed to prevent trauma. We aimed to compare the duration of tracheal intubation with S-Guide compared to Gliderite using a C-MAC® D-Blade® videolaryngoscope in patients with simulated difficult airways. Methods: We performed a single blinded prospective randomised study, with 50 adult patients requiring orotracheal intubation under general anaesthesia in Lausanne University Hospital. A cervical collar was fitted around patient’s neck to simulate difficult intubation conditions. Exclusion criteria were ASA>3, BMI > 35 kg/m2, known or at risk of difficult intubation and risk of aspiration of gastric content. We recorded T1: Time to identification of the glottis; T2: time to inflate the cuff and T3: total intubation time (capnography curve appearance). Secondary outcomes were the presence of arytenoid contact during intubation and post-operative airway discomfort Results: There were no significant differences between T1 and T2 (sec) while using the S- Guide or Gliderite respectively: 14.6 [9.6–18.6] vs 16.5 [11.0–20.6]; P=0.368 and 43.3 [33.2– 49.3] vs 46.3 [35.6–61.5], P=0.308. T3 (sec) was shorter in the S-Guide group: 58.1 [50.2–61.8] vs 65.3 [57.6–78.7], P=0.044. Fewer arytenoid contact occurred during intubation using the S- Guide (P=0.032), without difference in post-operative airway discomfort. Conclusion: S-Guide assisted tracheal intubation, with a C-MAC D-Blade in simulated difficult airways, allows successful and faster intubation than with the Gliderite Stylet