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LARYNGOSCOPE LIGHT INTENSITY MEASUREMENT

Department of Anesthesia, Dalhousie University, Queen Elizabeth Health Sciences Center, Halifax, Nova Scotia, Canada.

INTRODUCTION: The light illumination of fibreoptic blades (FOB) deteriorates with usage and repeated sterilization [1]. Some studies in the past have used luminance measurements which are clinical relevant but not readily available in the clinical setting [2]. The goal of the study was to determine the light intensity (illumination) of the fibreoptic blades that we currently used in our clinical setting and to compare the improvement in light intensity with a new 2.5-volt and a new 3.5-volt handle with this fleet of FOB.

METHODS: We used a LUX light meter (Tenma® digital light meter) and a prototype attachment to measure the light illumination of all the laryngoscope blades. The lux values were measured for 160 Heine (Herrsching, Germany) FOB with the 2.5-volt handles. These measurements were repeated for every blade with a new 2.5-volt and a new 3.5volt handle, batteries and bulb.

RESULTS: The mean (± SD) light intensity for all laryngoscope blades and handles as they were found on the 30 anesthesia carts at our institution was 869 (±519) lux. The light intensity was significantly improved with the new batteries. The mean (± SD) light intensities for all the laryngoscopes with the new 2.5 and 3.5-volt handle were 2091 (± 813) and 4066 (± 1790) lux respectively. The impact of putting a new FOB on each of our existing fibreoptic (FO) handles (with no consideration for batteries) was also measured. The average light intensity increased from 869 lux to 1740 lux.

DISCUSSION: Our data suggest that the light intensity of routinely used laryngoscopes was substantially increased with new batteries and blades. In fact, the light intensity improved by more than 2 fold and 4 folds with the use of a new 2.5 and new 3.5 volt laryngoscope handle respectively. Our cleaning process is low temperature pasteurization (70°C) which does not seem to decrease the illumination to the same degree as earlier reported [1]. While there is currently no information regarding the acceptable illumination sufficient for an effective laryngoscopy, our data suggest that vigilance with the battery power can substantially improve the illumination and perhaps enhance the visualization of the upper airway during direct laryngoscopy.

REFERENCES:

1 Bucx MJ, Veldman DJ, Beenhakker MM, Koster R, The effects of steam sterilization at 134 degrees C on light intensity provided by fibrelight Macintosh laryngoscopes. Anesthesia. 1999 Sept;54 (9):875–8

2 Skilton RW, Parry D, Arthurs GJ, Hiles P, A study of the brightness of laryngoscope light, Anesthesia. 1996 Jul; 51(7):667–72.

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