Laryngoscope Asssited Lightwand Intubation

Study Overview
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Brief Summary
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To evaluate the success rate for intubation of laryngocope assisted lightwand intubation.

Detailed Description
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Light wand intubation is well known for safety intubation in cervical injury patiets. Traditional method of using light wand can damage the supraglottic cavity by scooping the apparatus. The investigators try to evaluate the efficacy of laryngoscope assisted light wand intubation compared to traditional method of using light wand alone.

Official Title
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Laryngoscope Assisted Lightwand Can Provide More Successful Intubation Than Lightwand Alone in Patients With Cervical Spine Injury : A Prospective Randomized Study

Conditions
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Cervical Spine Surgery

Intervention / Treatment
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* Procedure: Laryngoscope assisted lightwand intubation
* Procedure: Lightwand intubation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient scheduled for cervical spine surgery under general anesthesia Exclusion Criteria: congenital or acquired abnormalities of the upper airway, tumours, polyps, trauma, abscesses, inflammation, or foreign bodies in the upper airway history of gastro-esophageal reflux disease, previous airway surgery, an increased risk of aspiration, coagulation disorders American Society of Anesthesiologists physical status ≥ 3

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Lightwand intubation<br>After standard total intravenous anesthesia using propofol and remifentanil continuous infusion, traditional lightwand intubation was done by pre-specified anesthesiologist who experienced more than 100 times of lightwand intubation. Patient's head were fixed at neutral position during all intubation period. | Procedure: Lightwand intubation<br>* After standard monitoring(EKG, pulse oximetry, NIBP), participants were induced with remifentanil and propofol continuous infusion, using targe-controlled infusion device with prexoygenation with 100% oxygen. Manual in-line stabilization was applied with velcro during intubation to maintain neutral head position. After 2min from administration of rocuronium, the clinician holds the wand similar to a pencil, stands directly behind the patient's head, inserts the device into the side of the mouth and sweeps the tip to the midline. After confirmation of precise location via clear light source on anterior neck, endotracheal tube was inserted and withdrawn lightwand.<br>* Other names: Surch-Lite, Aaron Medical Industries, St. Petersburg, FL;|
| Experimental: Laryngoscope assisted lightwand intubation<br>After standard total intravenous anesthesia using propofol and remifentanil continuous infusion, lightwand intubation using specific device(Macintosh laryngosope, female:3/Male:4) was done by pre-specified anesthesiologist who experienced more than 100 times of laryngoscope assisted lightwand intubation. | Procedure: Laryngoscope assisted lightwand intubation<br>* After standard monitoring(EKG, pulse oximetry, NIBP), participants were induced with remifentanil and propofol continuous infusion, using targe-controlled infusion device with prexoygenation with 100% oxygen. Manual in-line stabilization was applied with velcro during intubation to maintain neutral head position. The Macintosh laryngoscope (female: 3rd blade, male: 4th blade) was inserted into the oral cavity to provide direct view of the epiglottis and then the tip of the lightwand was placed below the epiglottis.<br>* Other names: lightwand (Surch-Lite, Aaron Medical Industries, St. Petersburg, FL);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The success rate of intubation | confirm the success intubation via end tidal CO2 measurement | up to 60 seconds | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| lightwand search (=intubation) time | Check the time(sec) from insertion of the lightwand or laryngoscopy into the oral cavity to push the endotracheal tube into the trachea. | from the insertion of the lightwand or laryngoscope into the oral cavity to the point of transillumination over the cricothyroid membrane within 60 sec. | 
| The times of scooping of lightwand | Within 1min after insertion of lightwand into oral cavity, check the scooping time of lightwand during intubation. | within 1min after insertion of lightwand |