“Light wand-guided nasotracheal intubation in patients with limited mouth opening: a comparison with blind nasal intubation”

Abstract

Background and objectives: Approximately 1–3% of surgical patients have difficult airways, which accounts for the most important cause of anaesthesia-related morbidity and mortality. The fibreoptic bronchoscope is considered the gold standard for the management of difficult airways. However, blind nasal intubation remains a basic technique in developing countries, especially in remote areas where a Fiberoptic bronchoscope is not always available. The light wand is a simple, cost effective device, and has become a tool widely accepted in airway management under various clinical scenarios, including difficult airways. The study was conducted to evaluate the efficacy of light wand-guided nasotracheal intubation over blind nasal intubation. Methods: A total of 60 ASA Grade I & II patients of age 18-60 yrs of Body mass index between 18-25 kg/m2 with limited mouth opening (distance between upper and lower central incisors < 3.0 cm) posted for elective surgeries were divided into two equal groups in a randomized, double-blind fashion. Blind nasal group 30 patients Light wand Group: 30 patients Results: The first attempt and overall success rate of light wand guided nasotracheal intubation was 80% and 90% respectively, significantly higher than blind nasal intubation i.e. 50% and 66.66% respectively (p