title: A double bending lightwand can provide more successful endotracheal intubation in patients with a short thyromental distance: a prospective randomised study.
abstract: OBJECTIVE
  This study assessed the efficacy of endotracheal intubation using a double bending lightwand in patients with an anticipated difficult airway because of a short thyromental distance.
  
  
  METHODS
  On the basis of the shape of the lightwand used, 68 patients with a thyromental distance of less than 65 mm undergoing general anaesthesia were randomly allocated to one of two groups. In the conventional bending group (n = 34), the lightwand was bent at 6.5 cm from the distal end to 90° angle. In the double bending group (n = 34), the lightwand was bent 30° at 15 cm from its tip in addition to the conventional bending. The ease of insertion was assessed by the lightwand search time and success rate at the first attempt. Post-operative complications, if any, were noted.
  
  
  RESULTS
  The success rate of intubation at the first attempt was higher for the double bending group (94 vs. 74%, P < 0.05). The search time was significantly shorter in the double bending group than the conventional bending group (10 ± 6 vs. 15 ± 8 s, P < 0.01). Mean blood pressure and heart rate increased after intubation in both groups (P < 0.05), but there were no significant differences between the groups. The incidence of post-operative sore throat and mucosal bleeding was not significantly different between the groups.
  
  
  CONCLUSIONS
  We conclude that the double bending lightwand is associated with a greater success rate of intubation in patients with an anticipated difficult airway because of a short thyromental distance.
authors.affiliation: Seoul National University Bundang Hospital Sungnam, Seoul, South Korea.
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Jeon
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Lim
authors.forename: Hyo-Seok
authors.initials: HS
authors.lastname: Na
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Park
authors.forename: Ah-Young
authors.initials: AY
authors.lastname: Oh
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Hwang
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Han
authors.forename: Hee-Pyoung
authors.initials: HP
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010612:Pharyngitis / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D013957:Thyroid Cartilage / Q000033:anatomy & histology*