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Anesth Analg 2004;99:279-283
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000118103.78553.06


GENERAL ARTICLES

Lightwand-Assisted Intubation of Patients in the Lateral Decubitus Position

Kuang-I Cheng, MD*, Koung-Shing Chu, MD{dagger}, Siu-Wah Chau, MD*, Soo-Lee Ying, MD*, Hong-Te Hsu, MD*, Yin-Lung Chang, MD*, and Chao-Shun Tang, PhD*

*Department of Anesthesiology, Kaohsiung Medical University, Kaohsiung, Taiwan, and the {dagger}Department of Anesthesiology, Kuo General Hospital, Tainan, Taiwan

Address correspondence and reprint requests to Chao-Shun Tang, PhD, No. 100, Shih-Chuan 1st Road, Department of Anesthesiology, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China. Address email to kuaich{at}kmu.edu.tw

In some situations, patients need endotracheal intubation to maintain airway patency while they are constrained in the lateral position. In this study we compared lightwand-guided intubation of 120 randomly enrolled patients placed in the supine, right, or left lateral position. Group S patients were initially placed in the supine position, and subsequent to the artificial airway having been established they were turned to the lateral decubitus position. Group R patients were initially placed in a right decubitus position during induction and intubation. Group L patients were initially placed in a left decubitus position during induction and intubation. The duration of each intubation attempt, the total time to successful intubation, and the incidence of intubation-related intraoral injury, hemodynamic changes, and postoperative sore throat and hoarseness were recorded. Intubation took a similar length of time in the supine (14.5 ± 13.4 s), left lateral (13.3 ± 10.2 s), and right lateral positions (15.5 ± 13.0 s) and resulted in a similar trend in hemodynamic changes. Patients in the lateral and supine positions revealed a comparable incidence of successful first-attempt intubation, sore throat, hoarseness, oral mucosal injury, and dysrhythmia. Insignificantly more esophageal intubations were performed in the lateral position in the first attempt at intubation; however, all patients were correctly intubated shortly after reattempting intubation. We concluded that lightwand-assisted intubation is easily performed and a similar technique may be used whether the patient is in a lateral, recumbent, or a supine position. This alternative technique should be practiced and is recommended for patients who must remain in a lateral position during intubation and surgery.

IMPLICATIONS: The skilled anesthesiologist can easily and effectively perform a lightwand-assisted intubation for patients in a lateral position. This alternative technique should be practiced before attempting it for the first time, and it is recommended for patients who must remain in a lateral position.




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Home page
Anesth. Analg.Home page
V. Dimitriou, J. Brimacombe, G. S. Voyagis, and C. Iatrou
Lightwand-Assisted Intubation of Patients in the Lateral Decubitus Position
Anesth. Analg., April 1, 2005; 100(4): 1219 - 1219.
[Full Text] [PDF]


Home page
Anesth. Analg.Home page
K.-I Cheng, K.-S. Chu, S.-W. Chau, and C.-S. Tang
Lightwand-Assisted Intubation of Patients in the Lateral Decubitus Position
Anesth. Analg., April 1, 2005; 100(4): 1219 - 1219.
[Full Text] [PDF]




Lippincott, Williams & Wilkins 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 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.