A randomized controlled trail comparing the visual stylet and visual laryngoscope for transoral single lumen tracheal intubation

Visual laryngoscope, as the most commonly used tracheal intubation tool in clinical practice, has a high intubation success rate and is quick to learn, but there are risks of over flexion of the neck, tooth loss, etc. The visual stylet helps to make up for these shortcomings. This study aimed to compare the effects of the visual stylet and visual laryngoscope on transoral single lumen tracheal intubation in non-difficult airways. The primary outcome was intubation time, and secondary outcomes included glottic exposure time, first success rates, hemodynamic indices, intubation-related complications. A total of 148 patients were included, with 75 in the visual stylet (VS) group and 73 in the visual laryngoscope (VL) group. The intubation time in the VS group was 35 (11) seconds, significantly shorter than the 41 (9) seconds in the VL group (P < 0.001). Immediately post-intubation, the MAP in the VS group was 80 (20.5) mmHg, lower than 87 (23) mmHg in the VL group (P < 0.01). Intubation-related complications are also lower in VS group compared to VL group. Other outcomes don't have significant difference. Our study has demonstrated that the visual stylet significantly reduces intubation time and provides more stable hemodynamics. For patients with limited mouth opening, shorter thyromental distance, or higher Cormack-Lehane grades, the visual stylet may potentially be a better choice compared to video laryngoscopy for tracheal intubation.Trial registration China Clinical Trial Registry (ChiCTR2100051812) (05/10/2021).