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Korean Journal of Anesthesiology 2008;54(5):519-523.
DOI: https://doi.org/10.4097/kjae.2008.54.5.519   
The Effect of Head Position on Tracheal Intubation using a Lightwand.
Won Tae Kim, Sang Hyun Kim, Won Seok Chae, Hee Cheol Jin, Jeong Seok Lee, Yong Ik Kim
Department of Anesthesiology and Pain Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea. yikim@schbc.ac.kr
Several methods have been attempted to enhance the success rate of tracheal intubation using a lightwand. Some studies have reported that changing the shape of a lightwand and the position of the head during intubation could influence the intubation time or success rate. However, there are no reports concerning the head position of a patient on influencing the success rate during tracheal intubation using a lightwand.
We enrolled 109 ASA physical status I and II patients scheduled for elective surgery under general anesthesia. Patients were randomly allocated to the sniffing group (n = 52) or neutral group (n = 57), depending on the head position. A lightwand (Surch-Lite(TM), Bovie/Aaron Medical, St. Petersburg, USA) was bent at 9.5 cm from the distal tip with a 0 cm extrusion for both groups of patients (J shape). The head was elevated by approximately 8 cm in the sniffing group of patients and by approximately 2 cm in the neutral group of patients, with the face straight up maintained by placement of a pillow.
The overall success rate at the first attempt was 98.1%. There were no differences in the mean intubation time between the two groups (sniffing group; 8.0 +/- 4.3 sec and neutral group; 9.3 +/- 4.1 sec). The mean intubation time tended to be longer in patients with modified Mallampati classification III than in patients with modified Mallampati classification I and II.
This study has demonstrated that the use of a J shaped lightwand did not affect the intubation time, regardless of the head position. The intubation time appears to be related to the airway condition when using a lightwand for tracheal intubation.
Key Words: lightwand; neutral; sniffing; tracheal intubation


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