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* From the Department of Anaesthesia, University School of Medicine, Campus Bio-Medico, Rome, Italy, and the
Department of Anaesthesia and Phamacology, Dalhousie University, Halifax, Nova Scotia, Canada.
Address correspondence to: Dr. Felice Agrò, Department of Anaesthesia, University School of Medicine Campus Bio-Medico, Via Longoni 69/83, 00155 Rome, Italy. Phone: 039-06-22541522; Fax: 039-06-22541444; E-mail f.agro{at}unicampus.it
Purpose: About 1% to 3% of laryngoscopic intubations can be difficult or impossible. Light-guided intubation has been proven to be an effective, safe, and simple technique. This article reviews current knowledge about the newer version lightwand: the TrachlightTM (TL).
Source: To determine its clinical utility and limitations, we reviewed the current literature (book and journal articles) on the TL since its introduction in 1995.
Principal findings: TL has been shown to be useful both in oral and nasal intubation for patients with difficult airways. It may also be useful in "emergency" situations or when direct laryngoscopy or fiberoptic endoscopy is not effective, such as with patients who have copious secretions or blood in the oropharynx. TL can also be used for tracheal intubation in conjunction with other devices (laryngeal mask airway -LMA-, intubating LMA, direct laryngoscopy). However, TL should be avoided in patients with tumours, infections, trauma or foreign bodies in the upper airway.
Conclusions: Based on the clinical reports available, the TL has proven to be a useful option for tracheal intubation. In addition, the device can also be used together with other intubating devices, such as the intubating LMA and the laryngoscope, to improve intubating success rates. A clear understanding of the principle of transillumination of the TL, and an appreciation of its indications, contraindications, and limitations, will improve the effectiveness of the device as well as reducing the likelihood of complications. Finally, regular practice with the TL with routine surgical patients requiring tracheal intubation will further improve intubation success rates.
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