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Intubation with Transillumination: Nasal or Oral?

Published online by Cambridge University Press:  28 June 2012

Georg A. Petroianu*
Affiliation:
University of Heidelberg at Mannheim, Mannheim, Germany
S. Subotic
Affiliation:
University of Heidelberg at Mannheim, Mannheim, Germany
P. Heil
Affiliation:
University of Heidelberg at Mannheim, Mannheim, Germany
A. Jatzko
Affiliation:
University of Heidelberg at Mannheim, Mannheim, Germany
W. H. Maleck
Affiliation:
City Hospital, Ludwigshafen, Germany
*
University of Heidelberg at Mannheim Department of Pharmacology Maybach Street 14-16 68169 Mannheim, Germany

Abstract

Transillumination-guided intubation is a useful back-up method when laryngoscopic intubation proves to be difficult or impossible. The Trachlight™ (Laerdal, N-4001 Stavanger, Norway) is suited for both nasal and oral use. Intubation times (intubation time) and success rates (success rate) for nasal and oral intubation with the Trachlight were compared.

Twenty-four medical students, inexperienced in intubation were instructed in the use of the Trachlight. A demonstration also was performed. Subsequently, they were asked to intubate a Laerdal Airway Management Trainer™ (Laerdal, Stavanger, Norway) using the Trachlight. Each student intubated 10 times orally and 10 times nasally (five times through the right and five times through the left nostril). The succession of the students was randomized The intubation times were measured and the position of the tube noted. Nasal and oral intubation times for the tenth trial (steady state conditions) were compared using the rank-order test for paired observations. Oral and nasal success rates were compared using the sign test for paired observations.

The differences between nasal and oral intubation concerning intubation time and the success rates were not significant. Nasal intubation with the Trachlight seems to be more difficult than the oral intubation.

Type
Brief Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1999

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References

1. Coryllos, PN: A method of combined endotracheal anesthesia and suction in thoracoplasty for pulmonary tuberculosis: Results in 41 cases. Curr Res Anesth Analg 1932;11:138143.CrossRefGoogle Scholar
2. Coryllos, PN: Etiology, prevention and treatment of postoperative hemorespiratory complications inthe surgical treatment of tubercolosis. J Thorac Surg 1933;2:384421.CrossRefGoogle Scholar
3. Macintosh, R, Richards, H: Device for blind nasal intubation. Anaesthesia 1957;12:223225.CrossRefGoogle Scholar
4. Yamamura, H, Yamamoto, T, Kamiyama, M: Illuminated introducer for endotracheal tubes. Anesthesiology 1959;20:221.Google Scholar
5. Ducrow, M: Throwing light on blind intubation. Anaesthesia 1978:33:827829.CrossRefGoogle ScholarPubMed
6. Ducrow, M: Throwing light on blind intubation. Anaesthesia 1980;35:81.CrossRefGoogle Scholar
7. Fox, DJ, Castro, T; Rastrelli, AJ: Comparison of intubation techniques in the awake patient: The Flexi-Lum™ surgical light (lightwand) vs blind nasal approach. Anesthesiology 1987;66:6971.CrossRefGoogle Scholar
8. Watson, CB, Clapham, M: Transillumination for correct tube positioning: Use of new fiberoptic endotracheal tube. Anesthesiology 1984;60:253.CrossRefGoogle ScholarPubMed
9. Stevens, SC, Hung, OR: A new device for oral and naso-tracheal light guided intubation. Can J Anaesth 1992;39:A86.Google Scholar
10. Benumof, JL: Definition and incidence of the difficult airway. Benumof, JL (ed): Airway Management: Principles and Practice. Mosby: St. Louis 1996. pp 121125.Google Scholar
11. Hung, OR, Pytka, S, Morris, I, Murphy, M, Stewart, RD: Clinical trial of new lightwand for tracheal intubation in patients with difficult airways. Can J Anaesth 1995;42:826830.CrossRefGoogle ScholarPubMed
12. Lipp, M, de Rossi, L, Daubländer, M, Thierbach, A: Die Transilluminationstechnik. Anaesthesist 1996;45:923930.CrossRefGoogle Scholar
13. Saha, AK, Higgins, M, Walker, G, Badr, A, Berman, L: Comparison of awake endotracheal intubation in patients with cervical spine disease: The lighted intubating stylet versus the fiberoptic bronchoscope. Anesth Analg 1998;87:477479.Google ScholarPubMed
14. Hung, OR, Pytka, S, Murphy, MF, Martin, B, Stewart, RD: An improved light-guided intubation technique for inexperienced intubators. Anesthesiology 1994;81:A623.CrossRefGoogle Scholar
15. Petroianu, GA, Maleck, WH, Jatzko, A, Altmannsberger, S, Bergler, WF: Intubation mit Transillumination: Unterweisung von Unerfahrenen am Modell. Anästhesiol Intensivmed 1996;37:511514.Google Scholar
16. Fisher, AQ, Tunkel, DE: Lightwand intubation of infants and children. J Clin Anesth 1997;9:275279.CrossRefGoogle ScholarPubMed
17. Petroianu, G, Maleck, W, Bergler, W, Rüfer, R: Carbon monoxide and non-quantitative carbon dioxide detection. Prehospital and Disaster Medicine 1996;11:276279.CrossRefGoogle Scholar
18. Petroianu, G, Maleck, W, Bergler, W, Rüfer, R: Sonomatic confirmation of tracheal intubation using the SCOTI. Prehospital and Disaster Medicine 1997;12:149153.CrossRefGoogle ScholarPubMed