K. Nishikawa et al., Comparison of the lightwand technique with direct laryngoscopy for awake endotracheal intubation in emergency cases, J CLIN ANES, 13(4), 2001, pp. 259-263
Study Objective: To clarify the efficacy of the lightwand technique compare
d with that of the conventional laryngoscopic technique for awake endotrach
eal intubation in patients requiring emergency surgery.
Design: Prospective clinical study.
Setting: Anesthesia department of a teaching hospital.
Patients: 60 ASA physical status LE patients undergoing emergency surgery.
Interventions: Awake intubations using the lightwand technique (LW group) a
nd a laryngoscope (LS group) were performed with conscious sedation with mi
dazolam and fentanyl.
Measurements and Main Results: Time to intubation and number of intubation
attempts in the LW group were significantly shorter and smaller, respective
ly, than those in the LS group (p < 0.01). Fewer LW group patients complain
ed of a sore throat than in the LS group. DeltaP [changes from "before intu
bation" to "immediately after intubation" in mean arterial pressure (MAP)]
in the LS group was significantly larger than that in the LW group (p < 0.0
5) although doses of sedatives in the two groups were not different. No hyp
oxemia or apnea associated with sedation was found in either of the groups.
Conclusions: The lightwand technique produces less magnitude of stress foll
owing tracheal intubation than does the conventional laryngoscopic techniqu
e for awake intubation. Lightwand-assisted awake intubation is thought to b
e a useful means for induction of anesthesia in cases of emergency surgery.
(C) 2001 by Elsevier Science Inc.