A Comparison of Light Wand and Suspension Laryngoscopic Intubation Techniques in Outpatients

• Published in: Anesthesia and analgesia Vol. 85; no. 3; pp. 578 - 582
• Main Authors: Friedman, Pamela G., Rosenberg, Michael K., Lebenbom-Mansour, Miriam
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01.09.1997; Lippincott
• Subjects: Adult; Ambulatory Surgical Procedures; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Arthroscopy; Biological and medical sciences; Deglutition Disorders - etiology; Female; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Hoarseness - etiology; Humans; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - methods; Laryngoscopy - adverse effects; Male; Medical sciences; Middle Aged; Pharyngitis - etiology; Postoperative Complications; Prospective Studies; Transillumination - instrumentation; Human; Light source; Guide; General anesthesia; Surgery; Complication; Suspension laryngoscopy; Ambulatory; Apparatus; Intubation; Technique; Trachea; Comparative study
• ISSN: 0003-2999
• DOI: 10.1097/00000539-199709000-00017

Endotracheal intubation can produce postoperative sore throat and hoarseness, as well as changes in cardiovascular variables.A major goal of ambulatory surgery is the prompt return of patients to their daily activities. Postoperative sore throat may impede this and may decrease patient satisfaction with their anesthetic and surgical experience. We conducted a prospective, randomized study in 40 outpatients having lower extremity arthroscopies to compare the effects of direct laryngoscopy and light wand intubation on cardiovascular changes, sore throat, hoarseness, and dysphagia. Subjects were randomly assigned to either Group A (endotracheal intubation by rigid laryngoscopy) or Group B (endotracheal intubation with a light wand). A standardized anesthetic technique was used. Heart rate and blood pressure were recorded before induction, after induction but before endotracheal intubation, and at 1-min intervals for the first 5 min after intubation. Sixteen to twenty-four hours postoperatively, the incidence and severity of sore throat, hoarseness, and dysphagia was assessed by a follow-up phone call. This study demonstrated no clinically significant difference in cardiovascular variables between the two techniques. Patients had a significantly lower incidence and severity of sore throat, hoarseness, and dysphagia when a light wand was used for intubation. In conclusion, this study suggests that light wand intubation may decrease the incidence and severity of postoperative sore throat, hoarseness, and dysphagia, thereby potentially increasing satisfaction in ambulatory surgical patients. ImplicationsThis prospective, randomized study found that the incidence and severity of postoperative sore throat, hoarseness, and difficulty in swallowing among ambulatory surgical patients is more frequent when they are endotracheally intubated with a rigid laryngoscope than with a light wand. The authors, therefore, recommend more frequent use of the light wand for endotracheal intubation.(Anesth Analg 1997;85:578-82)