Comparison of the Success Rates of Lightwand Tracheal Intubation on the First Attempt When Using the Lightwand at Different Angles

Kim, Min Kyun; Lee, Ji Hyang; Kim, Eun Ju; Lee, Sang Gon; Ban, Jong Suk; Min, Byung Woo

Clinical Research

General Article

Anesthesia and Pain Medicine 2007;2(4):252-256.
Published online October 30, 2007.

Comparison of the Success Rates of Lightwand Tracheal Intubation on the First Attempt When Using the Lightwand at Different Angles

Min Kyun Kim, Ji Hyang Lee, Eun Ju Kim, Sang Gon Lee, Jong Suk Ban, Byung Woo Min

Department of Anesthesiology and Pain Medicine, Fatima Hospital, Daegu, Korea. lovehan3@yahoo.co.kr

Abstract

BACKGROUND
It has been recommended that lightwand tracheal intubation be used for cases in which there is difficult airway management. Transillumination of the soft tissue of the neck by the lightwand can lead to successful intubation; however, this depends on skin color, obesity, head position, angle and the bent length of the lightwand. The goal of this study was to compare the success rates of intubation on the first attempt and complications of lightwand orotracheal intubation that occurred when using the lightwand at angles of 60 degrees and 90 degrees. METHODS: One hundred forty eight patients of ASA physical status 1 or 2 were enrolled in this study. Patients in whom intubation had previously been difficult as well as patients who had the potential for difficult intubation were excluded from this study. Patients were randomly assigned to one of two groups: The lightwand bent in 60 degrees (LW60) group and the lightwand bent in 90degrees (LW90) group. Anesthesia was performed using propofol (2 mg/kg), fentanyl (1microg/kg) and rocuronium (0.9 mg/kg), and lightwand orotracheal intubation was attempted 2 minutes after the induction of anesthesia. The success rates of intubation, the number of attempts and their duration, as well as hemodynamic changes, resistance to the tube and complications that occurred during the procedure were recorded. RESULTS: In the LW90 group, resistance to the tube during lightwand intubation occurred in a significant number of patients (P < 0.05), however, there were no significant differences observed between the two groups with regard to the intubation success rates on the first attempt, the duration of intubation, hemodynamic changes and complications. CONCLUSIONS: Their were no significant differences observed between intubation success rates on first attempt and complications when using a lightwand bent to 60 degrees or 90 degrees in patients without any previously known airway abnormalities.

Key Words: angle of lightwand, tracheal intubation, transillumination