Use of lightwand for nasotracheal intubation in adult patients with limited mouth opening undergoing elective surgery

Abstract

Objective:

Lightwand is a device which utilizes the principle of transillumination to assist endotracheal intubation.The authors evaluated the role of lightwand for nasotracheal intubation in patients having limited mouth opening on PAC assessment. Lightwand guided nasal intubation can be used for airway management where a fiberoptic bronchoscope is not always available. In elective surgery where the anesthetist has time to plan for airway management, lightwand can be an easy to use device.

Methodology:

Patients of either sexes, ASA physical status I or II, aged between 20 and 50 years, BMI (body mass index) between 18-25, and having mouth opening between 1-4 cm on PAC were included in our feasibility study. Ketofol (ketamine + propofol combination) was used to provide analgesic sedation. Lightwand was inserted into endotracheal tube and tip was bent into J shape before entering nasal cavity. Duration of procedure was calculated as the time between entry of lightwand into nose and starting of ETCO₂ waveform on monitor after attaching the breathing circuit. Our study evaluated the lightwand guided nasotracheal intubation, hemodynamic changes and incidence of airway complications in 40 adult non-pregnant patients. Heart rate, systolic, diastolic and mean blood pressures were measured at 0, 1, 2, 5 and 10 min. Statistical analysis was done by using SPSS version 20. Paired T-test was used to compare all the baseline values to different time intervals.