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An Evaluation of Retrograde Light-Guided Laryngoscopic Intubation and its Comparison with Conventional Direct Laryngoscopic Intubation


Affiliations
1 Department of Anaesthesiology and Critical Care, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi – 110002, Delhi, India

Background: Conventional Direct Laryngoscopic (DL) tracheal intubation requires certain amount of skill for its successful outcome. To improve the success of intubation, various alternatives to conventional laryngoscopy have been described in recent years. Retrograde Light-Guided Laryngoscopy (RLGL) is a recently described technique for endotracheal intubation. Methods: A prospective randomized study was conducted in 100 patients, randomly intubated according to a computer generated procedure using either DL or RLGL by a single operator. The primary outcome was the success rate of tracheal intubation. The parameters evaluated were: success rate of tracheal intubation, time to glottic exposure and time to tracheal intubation, Cormack and Lehane grades, haemodynamic parameters and post operative sore-throat and hoarseness of voice. Results: Compared with DL, the overall success rate was greater in the RLGL group (P = 0.004). This was associated with a shorter time to glottic exposure [4.0(±1.09) vs 4.72±(1.16) sec, P = 0.001], shorter intubation time [5.28(±1.34) vs 6.10(±1.22) sec, P < 0.001]. The laryngoscopic grades using RLGL were better than using DL (p = 0.002). The haemodynamic responses were comparable in both the groups. There was decreased incidence of sore-throat (p = 0.083) and hoarseness (0.005) at 24 hrs with RLGL compared to DL. Conclusions: RLGL is an alternative approach for intubation. We conclude that the RLGL is a safe and effective device for achieving endotracheal intubation in normotensive adults with normal airways.

Keywords

Airway, Endotracheal Intubation, Retrograde Light-Guided Laryngoscopy.
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  • An Evaluation of Retrograde Light-Guided Laryngoscopic Intubation and its Comparison with Conventional Direct Laryngoscopic Intubation

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Authors

Mohd Shakir Naeem
Department of Anaesthesiology and Critical Care, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi – 110002, Delhi, India
Kirti N. Saxena
Department of Anaesthesiology and Critical Care, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi – 110002, Delhi, India
Bharti Taneja
Department of Anaesthesiology and Critical Care, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi – 110002, Delhi, India

Abstract


Background: Conventional Direct Laryngoscopic (DL) tracheal intubation requires certain amount of skill for its successful outcome. To improve the success of intubation, various alternatives to conventional laryngoscopy have been described in recent years. Retrograde Light-Guided Laryngoscopy (RLGL) is a recently described technique for endotracheal intubation. Methods: A prospective randomized study was conducted in 100 patients, randomly intubated according to a computer generated procedure using either DL or RLGL by a single operator. The primary outcome was the success rate of tracheal intubation. The parameters evaluated were: success rate of tracheal intubation, time to glottic exposure and time to tracheal intubation, Cormack and Lehane grades, haemodynamic parameters and post operative sore-throat and hoarseness of voice. Results: Compared with DL, the overall success rate was greater in the RLGL group (P = 0.004). This was associated with a shorter time to glottic exposure [4.0(±1.09) vs 4.72±(1.16) sec, P = 0.001], shorter intubation time [5.28(±1.34) vs 6.10(±1.22) sec, P < 0.001]. The laryngoscopic grades using RLGL were better than using DL (p = 0.002). The haemodynamic responses were comparable in both the groups. There was decreased incidence of sore-throat (p = 0.083) and hoarseness (0.005) at 24 hrs with RLGL compared to DL. Conclusions: RLGL is an alternative approach for intubation. We conclude that the RLGL is a safe and effective device for achieving endotracheal intubation in normotensive adults with normal airways.

Keywords


Airway, Endotracheal Intubation, Retrograde Light-Guided Laryngoscopy.

References