The combined use of a lightwand and the intubating laryngeal mask airway (ILMA) was compared with the use of the ILMA alone to determine whether the combination was a more efficient method of endotracheal intubation. One hundred healthy patients were randomly assigned to two groups. After induction of anaesthesia, Group A patients were intubated blindly through the ILMA while in Group B, intubation was guided by a lightwand. A sequence of standard manoeuvres was followed if attempts at intubation failed. The number of manoeuvres used, the time taken for successful intubation and complications associated with intubation were recorded. Intubations were successful in all patients, but the mean endotracheal intubation time was longer in Group A than in Group B (38.3±10.4 s versus 26.4±9.1 s, P<0.001). The number of patients who needed one or more manoeuvres was significantly higher in Group A than in Group B (76% versus 42%, P=0.001). We conclude that the lightwand is a useful adjunct in endotracheal intubation through an ILMA.

Objective The effects of selective dorsal rhizotomy (SDR) on the hip development in children with spastic cerebral palsy (CP) are not well defined. The present study was performed to determine the effects of SDR and other associated clinical and radiological factors on the outcome of hip development after SDR. Methods The study included 53 patients who were skeletally immature at the time of SDR. Between 2003 and 2010, they underwent SDR at our institute. The age ranged from 4 to 15 years old. Their preoperative hip status was divided into two groups: normal and abnormal. The final outcome of the hip was considered good if the centre-edge angle of Wiberg (CEA) at last follow-up was more than 20 degrees without the need for orthopaedic intervention. Thirty-seven patients satisfied the inclusion criteria for statistical analysis. Results Seventeen patients were in the “Normal pre-op” group. In all patients (except for two patients), the hip status remained normal after the SDR. Twenty patients were in the “Abnormal pre-op” group. In this group, only two patients returned to normal hips, whereas 11 patients required orthopaedic hip surgery within 5 years after the SDR. The remaining seven patients had hip subluxation, but not to the extent of hip dislocation. The preoperative hip radiological measurements and functional status were positively correlated with the postoperative hip status. The preoperative radiological measurements showed superior predictive value when other covariance were considered. No difference of outcome existed in regard to the different surgical approaches of SDR. Conclusion Selective dorsal rhizotomy has a neutral effect on hip development. The preoperative hip radiological measurement is the most important predictive factor to determine hip status after SDR. Good collaboration between neurosurgeons and paediatric orthopaedists is essential for the best management of these patients.

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