title: Retrograde light-guided laryngoscopy for tracheal intubation: clinical practice and comparison with conventional direct laryngoscopy.
abstract: BACKGROUND
  Tracheal intubation with conventional laryngoscopy requires many trials until beginners are sufficiently skilled in intubating patients safely. To facilitate intubation, the authors used retrograde light-guided laryngoscopy (RLGL) and compared its feasibility with conventional direct laryngoscopy (DL).
  
  
  METHODS
  Twenty operators participated in a prospective, randomized, open-label, parallel-arm study. These operators intubated 205 patients randomly according to a computer-generated procedure by using either DL or RLGL (five intubations with each technique). The primary outcome was the success rate of tracheal intubation. The authors evaluated the success rate of tracheal intubation, the time to glottic exposure and tracheal intubation, and the Cormack and Lehane grades.
  
  
  RESULTS
  Compared with DL, the success rate was greater in the RLGL group for all five intubations (72% vs. 47%; rate difference, 25%; 95% CI [11.84-38.16%], P < 0.001). This was associated with a shorter time to glottic exposure (median [25th and 75th percentile]; 27 [15; 42] vs. 45 [30; 73] s, P < 0.001), shorter intubation time (66 [44; 120] vs. 120 [69; 120] s, P < 0.001), and decreased throat soreness (mean ± SD; visual analog scale, 2.1 ± 0.9 vs. 3.7 ± 1.0 cm, P = 0.001) in the RLGL group compared to the DL group.
  
  
  CONCLUSIONS
  RLGL is an alternative intubation technique. In our study, it enables beginners to intubate patients more successfully and quickly than conventional DL.
authors: Department of Anesthesiology and Intensive Care Medicine, Second Military Medical University, Shanghai, People's Republic of China.
authors: Tao
authors: T
authors: Yang
authors: Jiong
authors: J
authors: Hou
authors: Jinbao
authors: J
authors: Li
authors: Xu
authors: X
authors: Zhang
authors: Xiaoyan
authors: X
authors: Zhu
authors: Wen
authors: W
authors: Ni
authors: Yanfei
authors: Y
authors: Mao
authors: Xiaoming
authors: X
authors: Deng
mesh_terms: D000328:Adult; D005260:Female; D005931:Glottis / Q000033:anatomy & histology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D053208:Kaplan-Meier Estimate; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008027:Light; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010612:Pharyngitis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D014132:Trachea / Q000033:anatomy & histology; D016896:Treatment Outcome