A modified lightwand-guided nasotracheal intubation technique for oromaxillofacial surgical patients.
OBJECTIVE
To investigate the efficiency of a double curve nasotracheal tube on lightwand-guided nasotracheal intubation.


METHODS
Prospective, randomized, controlled trial.


METHODS
University medical center hospital.


METHODS
60 ASA physical status I and II patients undergoing oromaxillofacial surgery.


METHODS
Patients undergoing surgery with nasotracheal intubation and general anesthesia were randomly enrolled in the laryngoscopy group or the lightwand group. The same type of double curve nasotracheal tube was used in both groups. In the laryngoscopy group, intubation was assisted with a Macintosh No. 3 standard curved blade and Magill forceps. In the lightwand group, intubation was aided with a flexible lightwand device (without the inner stiff stylet). Intubation time was divided into two parts: Part one, from selected naris to oropharynx; Part two, from oropharynx into trachea. Part one, Part two, and total intubation time, hemodynamic responses to nasotracheal intubation, and adverse events or complications were recorded.


RESULTS
Total intubation times in the lightwand group and the laryngoscopy group were 22.8 +/- 8.0 sec vs 30.3 +/- 8.2 sec (P < 0.001), respectively. The lightwand group had comparable hemodynamic responses to those of the laryngoscopy group. Adverse events and complications were all self-limited, with similar occurrence in both groups.


CONCLUSIONS
For patients undergoing oromaxillofacial surgery, modified lightwand-guided nasotracheal intubation is feasible with a double curve nasotracheal tube and is an efficient alternative technique.
Cheng
Kuang-I
KI
Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.
Chang
Ming-Chih
MC
Lai
Ta-Wei
TW
Shen
Ya-Chun
YC
Lu
David-vi
DV
Lai
Shang-Tsung
ST
Chen
Chung-Ho
CH
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D007828:Laryngoscopy / Q000009:adverse effects / Q000379:methods*; D008027:Light; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D013515:Surgery, Oral / Q000379:methods*; D013997:Time Factors; D055815:Young Adult