Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-28T01:24:35.608Z Has data issue: false hasContentIssue false

A comparison of the use of Trachlight® and Eschmann multiple-use introducer in simulated difficult intubation

Published online by Cambridge University Press:  29 August 2006

K. Harvey
Affiliation:
University Hospital of Wales and Cardiff University, Cardiff, UK
R. Davies
Affiliation:
University Hospital of Wales and Cardiff University, Cardiff, UK
A. Evans
Affiliation:
University Hospital of Wales and Cardiff University, Cardiff, UK
I. P. Latto
Affiliation:
University Hospital of Wales and Cardiff University, Cardiff, UK
J. E. Hall
Affiliation:
University Hospital of Wales and Cardiff University, Cardiff, UK
Get access

Extract

Summary

Background and objective: The Eschmann multiple-use introducer is widely used in the management of difficult intubations. Transillumination of the neck is less commonly used. We conducted a randomized crossover study comparing the Trachlight® lightwand and Eschmann multiple-use introducer in simulated difficult intubation. Methods: Sixty-four healthy patients were studied using a standard anaesthetic and full muscle relaxation assessed by train of four. A Macintosh laryngoscope was then inserted and then lowered to simulate a Grade 3 view. Tracheal placement was attempted with both Trachlight® lightwand and Eschmann multiple-use introducer in a randomized order. Anaesthetists placing the devices had extensive experience with the Eschmann multiple-use introducer, but only 15 previous uses of the Trachlight®. Success rates and time for tracheal placement were recorded. Results: The Eschmann multiple-use introducer and Trachlight® were successfully placed in 96.8% and 93.7%, respectively (n.s.). Mean (SD) time to intubation for Eschmann multiple-use introducer and Trachlight® were 15(6) and *21(13), respectively (*P < 0.001). Conclusion: The Trachlight® is a potentially useful alternative to the Eschmann multiple-use introducer in difficult intubation.

Type
Original Article
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cook TM. A new classification of laryngeal view. Anaesthesia 2000; 55: 274279.Google Scholar
Rose DK, Cohen MM. The airway: problems and predictions in 18,500 patients. Can J Anaesth 1996; 43: 3034.Google Scholar
Wilson ME. Predicting difficult intubation. Br J Anaesth 1993; 71: 333334.Google Scholar
Latto IP, Stacey M, Mecklenburgh J, Vaughan RS. Survey of the use of the gum elastic bougie in clinical practice. Anaesthesia 2002; 57: 379384.Google Scholar
Rosenblatt WH, Wagner PJ, Ovassapian A, Kain ZN. Practice patterns in managing the difficult airway by anesthesiologists in the United States. Anesth Analg 1998; 87: 153157.Google Scholar
Hung OR, Pytka S, Morris I et al. Clinical trial of a lightwand intubation device (Trachlight) to intubate the trachea. Anesthesiology 1995; 83: 509514.Google Scholar
Hung O, Stewart R. Lightwand intubation: I – a new lightwand device. Can J Anaesth 1995; 42: 820825.Google Scholar
Agro F, Benumof J, Carassiti M, Cataldo R, Gherardi S, Barzoi G. Efficacy of a combined technique using the Trachlight together with direct laryngoscopy under simulated difficult airway conditions in 350 anesthetized patients. Can J Anaesth 2002; 49: 525526.Google Scholar
Agro F, Hung O, Cataldo R, Carassiti M, Gherardi S. Lightwand intubation using the Trachlight®: a brief review of current knowledge. Can J Anaesth 2001; 48: 592599.Google Scholar
Ellis DG, Stewart RD, Kaplan RM et al. Success rates of blind orotracheal intubation using a transillumination technique with a lighted stylet. Ann Emerg Med 1986; 15: 138142.Google Scholar
Gataure PS, Vaughan RS, Latto IP. Simulated difficult intubation – comparison of the gum elastic bougie and the stylet. Anaesthesia 1996; 51: 935938.Google Scholar
Noguchi T, Koga K, Shiga Y, Shigematsu A. The gum elastic bougie eases tracheal intubation while applying cricoid pressure compared to a stylet. Can J Anaesth 2003; 50: 712717.Google Scholar
Nishiyama T, Matsukawa T, Hanaoka K. Safety of a new lightwand device (Trachlight[™]): temperature and histopathological study. Anesth Analg 1998; 87: 717718.Google Scholar
Yentis SM, Lee DJH. Evaluation of an improved scoring system for grading of direct laryngoscopy. Anaesthesia 1998; 53: 10411044.Google Scholar
Kidd JF, Dyson A, Latto IP. Successful difficult intubation. Use of the gum elastic bougie. Anaesthesia 1988; 43: 437438.Google Scholar
Hung O, Pytka S, Morris I, Murphy M, Stewart R. Lightwand intubation: II – clinical trial of a new lightwand for tracheal intubation in patients with difficult airways. Can J Anaesth 1995; 42: 826830.Google Scholar
Nolan JP, Wilson ME. An evaluation of the gum elastic bougie. Intubation times and incidence of sore throat. Anaesthesia 1992; 47: 878881.Google Scholar
Dogra S, Falconer R, Latto IP. Increased use of gum-elastic bougie in clinical practice. Anaesthesia 1990; 45: 997998.Google Scholar
Sellers WFS, Jones GW. Difficult tracheal intubation. Anaesthesia 1986; 41: 93.Google Scholar
Morris J, Cook TM. Rapid sequence induction: a national survey of practice. Anaesthesia 2001; 56: 10901097.Google Scholar
Hodzovic I, Latto IP, Henderson JJ. Bougie trauma – what trauma? Anaesthesia 2003; 58: 192193.Google Scholar
Kadry M, Popat M. Pharyngeal perforation – an unusual complication of blind intubation with a gum elastic bougie. Anaesthesia 1999; 54: 404405.Google Scholar
Cupitt JM. Microbial contamination of gum elastic bougies. Anaesthesia 2000; 55: 466468.Google Scholar
Miller DM, Youkhana I, Karunaratne WU, Pearce A. Presence of protein deposits on ‘cleaned’ re-usable anaesthetic equipment. Anaesthesia 2001; 56: 10691072.Google Scholar
The Association of Anaesthetists of Great Britain and Ireland. Infection Control in Anaesthesia, November 2002.
Marfin AG, Pandit JJ, Hames KC, Popat MT, Yentis SM. Use of the bougie in simulated difficult intubation. 2. Comparison of single-use bougie with multiple-use bougie. Anaesthesia 2003; 58: 852855.Google Scholar
Annamaneni R, Hodzovic I, Wilkes AR, Latto IP. A comparison of simulated difficult intubation with multiple-use and single-use bougies in a manikin. Anaesthesia 2003; 58: 4549.Google Scholar
Hodzovic I, Latto IP, Wilkes AR, Hall JE, Mapleson WW. Evaluation of Frova, single-use introducer, in a manikin. Comparison with Eschmann multiple-use introducer and Portex single-use introducer. Anaesthesia 2004; 59: 811816.Google Scholar
Kihara S, Brimacombe J, Yaguchi Y, Watanabe S, Taguchi N, Komatsuzaki T. Hemodynamic responses among three tracheal intubation devices in normotensive and hypertensive patients. Anesth Analg 2003; 96: 890895.Google Scholar
Takahashi S, Mizutani T, Miyabe M, Toyooka H. Hemodynamic responses to tracheal intubation with laryngoscope versus lightwand intubating device (Trachlight®) in adults with normal airway. Anesth Analg 2002; 95: 480484.Google Scholar
Nishikawa K, Omote K, Kawana S, Namiki A. A comparison of haemodynamic changes after endotracheal intubation by using the lightwand device and the laryngoscope in normotensive and hypertensive patients. Anesth Analg 2000; 90: 12031207.Google Scholar
Morton T, Brady S, Clancy M. Difficult airway equipment in English emergency departments. Anaesthesia 2000; 55: 485488.Google Scholar
Rosenblatt WH, Wagner PJ, Ovassapien A, Kain ZN. Practice patterns in managing the difficult airway by anesthiologists in the United States. Anesth Analg 1998; 87: 153157.Google Scholar
Hodgson RE, Gopalan PD, Burrows RC, Zuma K. Effect of cricoid pressure on the success of endotracheal intubation with a lightwand. Anesthesiology 2001; 94: 259262.Google Scholar
Ainsworth QP, Howells TH. Transilluminated tracheal intubation. Br J Anaesth 1989; 62: 494497.Google Scholar
Asai T, Latto IP, Muthuswamy D, Kiyama S. Equipment list for difficult airway management. Anaesthesia 2004; 59: 922.Google Scholar