The purpose of this randomized, prospective study was to compare the intubation time, hemodynamic effect and complication rates of orotracheal intubation performed by direct laryngoscopic or lighted stylet (lightwand) methods in the controlled
settings
of the operating room. After approval of clinical investigation committee and informed consent from patients, healthy ASA class 1 and 2 elective surgical patients were studied. On arrival to operating room, EKG, radial arterial cannulation to
monitor
blood pressure continuously and neuromuscular monitoring device were applied to patients. Anesthesia was induced with fentanyl 3 μg/kg, thiopental 4 mg/kg and vecuronium 0.15 mg/kg to facilliate relaxation. Ventilation was controlled for 5 min
by
facemask with oxygen-isoflurane (1.2 vol%) or enflurane(1.7 vol%) before intubation. The patients were intubated randomly using either direct curved laryngoscope (DL, 37 patients) or lightwand (LW, 3.6 patients). The time to intubation (TTI) was
recorded. The mean arterial pressure(MAP) and heart rate(HR) were recoreded every 30 sec after intubation for 5 min. The changes of MAP and HR after intubation were compared with pre-intubation value. After extubation, complications such as
mucosal
trauma and postoperative sore throat were recorded. The data were analyzed using either unpaired t-test or Chi-square analysis, where appropriate. There were no failed intubations in either groups. There was no significant differences between the
groups
with respect to sex, age, weight, height, existence of nasogastric tube. The TTI was similar between groups(14.5(8.1 sec for LW, 16.8±9.5 sec for DL). There was no differences in incidence of trauma(19.4% for LW, 16.2% for DL) between groups.
There
were no statistically significant difference in the maximal increase in Map (44% for LW, 55% for DL at 30 sec) and HR(25.6% for LW, 24.1% for DL at 30 sec) and during 5 min following intubation.
In conclusion, even though the hemodynamic effect after intubation was not influenced by using LW, the results of this study indicate that the use of the LW is as useful, effective and safe method as using DL for oro-endotracheal intubation.
Further
study may prove that using the LW to be an effective alternative technique of intubation in patients with difficult airway.
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