Comparison of the lightwand technique with direct laryngoscopy for awake endotracheal intubation in emergency cases
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Published on: August 2, 2024
K Nishikawa1, S Kawana, A Namiki
1Department of Anesthesiology, Sapporo Medical University, School of Medicine, Sapporo, Japan.
Study Objective:
To clarify the efficacy of the lightwand technique compared with that of the conventional laryngoscopic technique for awake endotracheal intubation in patients requiring emergency surgery.
Design:
Prospective clinical study.
Setting:
Anesthesia department of a teaching hospital.
Patients:
60 ASA physical status IE patients undergoing emergency surgery.
Interventions:
Awake intubations using the lightwand technique (LW group) and a laryngoscope (LS group) were performed with conscious sedation with midazolam and fentanyl.
Measurements And Main Results:
Time to intubation and number of intubation attempts in the LW group were significantly shorter and smaller, respectively, than those in the LS group (p < 0.01). Fewer LW group patients complained of a sore throat than in the LS group. DeltaP [changes from "before intubation" to "immediately after intubation" in mean arterial pressure (MAP)] in the LS group was significantly larger than that in the LW group (p < 0.05), although doses of sedatives in the two groups were not different. No hypoxemia or apnea associated with sedation was found in either of the groups.
Conclusions:
The lightwand technique produces less magnitude of stress following tracheal intubation than does the conventional laryngoscopic technique for awake intubation. Lightwand-assisted awake intubation is thought to be a useful means for induction of anesthesia in cases of emergency surgery.
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