USE OF A LIGHTED STYLET FOR INTUBATION VIA THE LARYNGEAL MASK AIRWAY

Purpose: To assess a new technique for intubation via the laryngeal ma sk airway (LMA) in which a lighted stylet is used to optimise the posi tion of the LMA before intubation, Methods: In 114 patients, following LMA insertion, the lighted stylet (Trachlight Wand(TM)) with mounted tracheal tube (TT)was advanced 1.5 cm beyond the mask aperture bars an d the anterior neck observed for a distinct central point of light at the cricothyroid membrane (CTM). If this was not seen, the IMA was rep ositioned in the pharynx, depending on the location of the light, by m anually advancing, withdrawing or rotating the device, manipulating th e head/neck or trying an alternative size, Tracheal intubation was att empted only when transillumination was correct, The TT with lighted st ylet was advanced until the supra-sternal notch was transilluminated, Results: in 89 patients (78%) the CTM was transilluminated without rep ositioning, in 12 (10%) a single positional adjustment was required, a nd in 10 (9%) a change of LMA size was required. in three patients (3% ) transillumination of the CTM was impossible. in the 97% of patients in whom transillumination was correct, tracheal intubation was success ful in all at the first attempt without the need for further repositio ning or size change. Conclusion: The lighted stylet is useful in facil itating intubation via the IMA in anaesthetised adult patients when us ed as a guide to optimal LMA position.