Evaluation of transmitted glow point at <i>a priori</i> chosen depth (1 cm below vocal cords) for lightwand intubation: a prospective observational study

Cho, Eunyoung; Kim, Hyun-Chang; Lee, Jung Man; Park, Ji Hoon; Ha, Najeong; Hong, Ji Hee; Lee, Jiwon

doi:10.1177/0300060520974249

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…In our study, we stopped at the brightest point during lightwand insertion. Cho et al reported that 1 cm below the vocal cords was an effective glow point for the lightwand tip to avoid deep or shallow insertions (21). They showed a 93.5% success rate at the first attempt, which was similar to our results.…”

Section: Discussionsupporting

confidence: 91%

Evaluation of Factors Affecting Illumination Intensity in Lightwand Endotracheal Intubation

HONG,

LEE,

HWANG

et al. 2023

In Vivo

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Background/Aim: A lightwand is a stylet with a light bulb at its tip that can be used to guide intubation by confirming the illumination through the anterior neck. We aimed to determine the factors affecting the illumination intensity during lightwand endotracheal intubation. Patients and Methods: We retrospectively collected data from 180 patients who underwent lightwand endotracheal intubation. We recorded illumination intensity on a 5-point scale. The patients were categorized into weak (score <3) and bright (score ≥3) groups based on the illumination intensity scale score. Results: A total of 176 patients were analyzed, of whom 125 (71.1%) were enrolled in the bright group, and 51 (29.0%) were enrolled in the weak group. Multivariable logistic regression analysis revealed that an increased body mass index (BMI) and mask ventilation grade were associated with light intensity. For mask ventilation, moderate vs. easy (p=0.010) and difficult vs. easy (p=0.008) were associated with the weak group. Receiver operating characteristic curve analysis showed that BMI ≥24.6 kg/m 2 was correlated with the weak group. Conclusion: BMI ≥24.6 kg/m 2 or mask ventilation grade above moderate indicates increased odds of weak illumination intensity in lightwand intubation. Pre-intubation examination of these factors helps increase the chances of successful intubation.Successful intubation is of great importance for airway management during general anesthesia. Although intubation techniques and tools have rapidly developed, the lightwand, which has long been used in airway management, still has benefits. Lightwand intubation is a technique in which a lightbulb stylet is introduced into the endotracheal tube and the tube tip is directed into the trachea by transillumination through the anterior neck tissue (1). The lightwand has been recommended for difficult airway management by the American Society of Anesthesiologists (ASA) (2). When mask ventilation is adequate, but intubation is unsuccessful, alternative noninvasive approaches can be attempted using a lightwand, laryngeal mask airway, or different laryngoscope blades (nonemergency pathways) (1, 2). In 2022, the ASA updated their recommendations concerning the suggested equipment for the management of difficult airways (3). In particular, they suggested non-invasive and invasive alternatives by emphasizing awareness of the passage of time and limiting the number of attempts using different devices and techniques (3). Non-invasive devices include lighted or optical stylets, videolaryngoscopes, flexible intubation scopes, and adjuncts (3). In anticipated difficult airway management, if a noninvasive approach is selected, they recommend identifying a preferred sequence of non-invasive devices (3). The lightwand is easy to carry and prepare, inexpensive, and easy for physicians to learn (4). A lightwand can be a valuable disposable intubation tool for difficult intubation (5), particularly during the COVID-19 pandemic. After the 490

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Section: Discussionsupporting

confidence: 91%

Evaluation of Factors Affecting Illumination Intensity in Lightwand Endotracheal Intubation

HONG,

LEE,

HWANG

et al. 2023

In Vivo

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“…[12] However, the use of video laryngoscopy may be limited in patients with restricted opening and cervical ankylosis. [13] Tracheal intubation using a lightwand is a good alternative for patients with restricted opening and cervical ankylosis. Therefore, in this case, we chose to use a lightwand-guided tracheal intubation that is easy to perform and does not require exposure of the vocal cords.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of patients with difficult intubation due to temporomandibular joint osteoarthritis: A case report

Rao,

Huang,

et al. 2024

Medicine

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Introduction: Temporomandibular joint osteoarthritis (TMJOA) affects 8% to 16% of the global population, yet TMJOA remains relatively underappreciated clinically. To anesthesiologists, who is concerned about patient safety, adequate preoperative evaluation and preparation, as well as individualized anesthetic management of patients, are necessary. Therefore, the anesthesiologist should be alert for difficult airways due to TMJOA, have a full and comprehensive understanding of the disease, and possess the appropriate expertise for difficult airway intubation. Case presentation: A 52-year-old female patient was scheduled for laparoscopic operation of uterine adnexa under general anesthesia. The patient preoperative evaluation showed only 1 finger width of mouth opening, and the computed tomography scan showed bilateral temporomandibular arthritis, which was evident on the right side. Intraoperatively, the expected airway difficulties occurred, and the anesthesiologist opted to use lightwand intubation, which was ultimately successful in 1 pass without any complications. Conclusion: Intubation using a lightwand for patients with difficult intubation due to TMJOA is a very effective intubation modality.

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Evaluation of transmitted glow point at a priori chosen depth (1 cm below vocal cords) for lightwand intubation: a prospective observational study

Cited by 2 publications

References 30 publications

Evaluation of Factors Affecting Illumination Intensity in Lightwand Endotracheal Intubation

Evaluation of Factors Affecting Illumination Intensity in Lightwand Endotracheal Intubation

Anesthetic management of patients with difficult intubation due to temporomandibular joint osteoarthritis: A case report

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