title: A modified lightwand-guided nasotracheal intubation technique for oromaxillofacial surgical patients.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.
authors.forename: Kuang-I
authors.initials: KI
authors.lastname: Cheng
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Chang
authors.forename: Ta-Wei
authors.initials: TW
authors.lastname: Lai
authors.forename: Ya-Chun
authors.initials: YC
authors.lastname: Shen
authors.forename: David-vi
authors.initials: DV
authors.lastname: Lu
authors.forename: Shang-Tsung
authors.initials: ST
authors.lastname: Lai
authors.forename: Chung-Ho
authors.initials: CH
authors.lastname: Chen
mesh_terms: 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