Removal of the stylet from the tracheal tube: effect of lubrication

We compared the work needed to retract a non-lubricated and a lubricated stylet from a tracheal tube over 24 h. Stylets were lubricated with sterile water, silicone fluid, lidocaine spray, lidocaine gel, MedPro(®) lubricating gel or Lacri-Lube(®). The mean (SD) work in joules needed to retract the stylet by 5 cm from the tracheal tube was recorded immediately (time 0), at 5 and 30 min and at 1, 3 and 24 h. At time 0 lubrication with sterile water (0.53 (0.09); p = 0.001), silicone fluid (0.43 (0.10); p < 0.001), lidocaine gel (0.60 (0.15); p = 0.01) and MedPro gel (0.57 (0.07); p = 0.005), were better than no lubrication (0.94 (0.28)). Where a tracheal tube is pre-loaded with a stylet for use at an indeterminate time, silicone fluid was the best choice of lubricant as it performed consistently well up to 24 h. At 24 h only silicone fluid (0.49 (0.01)) outperformed no lubrication (0.77 (0.24); p = 0.04).