A comparison of single-handed chin lift and two-handed jaw thrust for tracheal intubation using a lightwand.
In the present study, we evaluated the effects of single-handed chin lift and two-handed jaw thrust on lightwand-guided intubation and postoperative sore throat.



Sixty adult patients were included in the study. After induction of anesthesia, intubation was performed using a lightwand under single-handed chin lift or two-handed jaw thrust. In the single-handed chin lift group, the lightwand was inserted with the right hand after the mandible was lifted by placing the thumb of the left hand into the mouth. In the two-handed jaw thrust group, the lightwand was inserted while jaw thrust was achieved by an assistant using two hands. Lightwand search time, number of intubation attempts, and time to achieve intubation were assessed. Heart rate and mean arterial pressure were measured before and after intubation. Postoperative sore throat was evaluated at 1 and 24 h after surgery.



Lightwand search time was significantly shorter in the two-handed jaw thrust group compared to the single-handed chin lift group (7.2 ± 4.6 vs. 12.1 ± 9.1 s, respectively; p = 0.016). The two-handed jaw thrust group had shorter intubation time than the single-handed chin lift group (21.0 ± 6.6 vs. 27.9 ± 9.9 s, respectively; p = 0.004). The number of intubation attempts and hemodynamic changes during intubation were similar between the two groups. The incidence and severity of postoperative sore throat were lower at 24 h after surgery in the two-handed jaw thrust group compared with the single-handed chin lift group (p = 0.011).



The two-handed jaw thrust facilitated lightwand-guided intubation, and reduced the incidence and severity of postoperative sore throat compared to the single-handed chin lift.
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Seong-Mi
SM
Yang
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro 5, Dongjak-gu, Seoul, 07061, Republic of Korea.
Hyerim
H
Kim
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro 5, Dongjak-gu, Seoul, 07061, Republic of Korea.
Jee-Eun
JE
Chang
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro 5, Dongjak-gu, Seoul, 07061, Republic of Korea.
Seong-Won
SW
Min
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro 5, Dongjak-gu, Seoul, 07061, Republic of Korea.
Jung-Man
JM
Lee
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Boramae-ro 5, Dongjak-gu, Seoul, 07061, Republic of Korea. mistyblue15@naver.com.
Jin-Young
JY
Hwang
D000368:Aged; D062186:Arterial Pressure; D002680:Chin; D005260:Female; D006339:Heart Rate; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008029:Lighting / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D010612:Pharyngitis / Q000453:epidemiology; D014132:Trachea / Q000000981:diagnostic imaging
Lightwand; Single-handed chin lift; Sore throat; Two-handed jaw thrust