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.