The Shikani Seeing Stylet for difficult intubation in children: initial experience

Area of Science:

• Anesthesiology
• Medical Devices
• Pediatric Airway Management

Background:

• The Shikani Seeing Stylet is a novel reusable intubating stylet combining fiberoptic bronchoscope and lightwand features.
• It is designed for use in adult and pediatric patients, featuring a malleable stainless steel sheath with a fiberoptic cable, distal light source, and high-resolution lens.

Purpose of the Study:

• To evaluate the efficacy and utility of the Shikani Seeing Stylet in pediatric patients with potentially difficult airways.
• To assess the success rate of tracheal intubation using this device in a challenging pediatric population.

Main Methods:

• The study involved eight intubation attempts in seven pediatric patients preoperatively identified as having difficult airways.
• Patients were managed with inhalational anesthesia, followed by direct laryngoscopy (Grade 3 in six, Grade 1 in one).
• The Shikani Seeing Stylet was then used for tracheal intubation, with most attempts performed by anesthesiologists without prior experience with the device.

Main Results:

• Seven out of eight tracheal intubations were successful using the Shikani Seeing Stylet.
• One failure occurred in a patient who was ultimately un-intubatable by any method.
• The device was utilized by different anesthesiologists on six occasions, none having prior clinical experience.

Conclusions:

• The Shikani Seeing Stylet appears to be a valuable tool for tracheal intubation in children with difficult airway problems.
• Its utility is particularly noted in cases of suspected cervical spine instability or limited mouth opening.
• The device's portability, cost-effectiveness, and ease of maintenance contribute to its potential as a useful adjunct in pediatric anesthesiology.