Study objective: To clarify the efficacy of the lightwand technique compared with that of the conventional laryngoscopic technique for awake endotracheal intubation in patients requiring emergency surgery.
Design: Prospective clinical study.
Setting: Anesthesia department of a teaching hospital.
Patients: 60 ASA physical status IE patients undergoing emergency surgery.
Interventions: Awake intubations using the lightwand technique (LW group) and a laryngoscope (LS group) were performed with conscious sedation with midazolam and fentanyl.
Measurements and main results: Time to intubation and number of intubation attempts in the LW group were significantly shorter and smaller, respectively, than those in the LS group (p < 0.01). Fewer LW group patients complained of a sore throat than in the LS group. DeltaP [changes from "before intubation" to "immediately after intubation" in mean arterial pressure (MAP)] in the LS group was significantly larger than that in the LW group (p < 0.05), although doses of sedatives in the two groups were not different. No hypoxemia or apnea associated with sedation was found in either of the groups.
Conclusions: The lightwand technique produces less magnitude of stress following tracheal intubation than does the conventional laryngoscopic technique for awake intubation. Lightwand-assisted awake intubation is thought to be a useful means for induction of anesthesia in cases of emergency surgery.