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NEUROSURGICAL ANESTHESIA

A Comparison of Two Tracheal Intubation Techniques with Trachlight^TM and Fastrach^TM in Patients with Cervical Spine Disorders

Yoshitaka Inoue, MD PhD^*, Kazunori Koga, MD PhD, and Akio Shigematsu, MD PhD

*Labor Welfare Corporation, Spinal Injuries Center, University of Occupational and Environmental Health, School of Medicine, Fukuoka, Japan

Address correspondence and reprint requests to Yoshitaka Inoue, MD, PhD, Department of Anesthesia, Labor Welfare Corporation, Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-8508 Japan. Address e-mail to y0inouwe{at}pastel.ocn.ne.jp

Optimal airway management strategies in patients with an unstable cervical spine remain controversial. A newly designed lightwand device (Trachlight^TM) or an intubating laryngeal mask (Fastrach^TM) may avoid hyperextension of the neck. However, there are few objective data that guide us in selecting the appropriate devices. We conducted a prospective randomized study in 148 patients who received general anesthesia for whom the operations were related to the clinical and/or radiographic evidence of cervical abnormality. Trachlight^TM or Fastrach^TM was used for tracheal intubation with the head and neck held in a neutral position. In the Trachlight^TM group, intubation was successful at the first attempt in 67 of 74 (90.5%) cases and at the second attempt in 5 (6.8%) cases. In contrast, in the Fastrach^TM group, 54 of 74 (73.0%) patients were intubated within our protocol. The mean time for successful tracheal intubation at the first attempt was significantly shorter in the Trachlight^TM group than in the Fastrach^TM group. The Trachlight^TM may be more advantageous for orotracheal intubation in patients with cervical spine disorders than the Fastrach^TM with respect to reliability, rapidity, and safety.

IMPLICATIONS: The Trachlight^TM may be more advantageous for orotracheal intubation in patients with cervical spine disorders than the Fastrach^TM with respect to reliability, rapidity and safety.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999