Lighted Stylet Tracheal Intubation: A Review

Tracheal intubation using the Airtraq®: a comparison with the lightwand

“…The lightwand is often used because the technique is easy and safe and involves less cervical spine movement than direct Macintosh laryngoscopy [7]. However, since the lightwand is a blind technique, it should be avoided in patients with known anatomical abnormalities of the upper airway such as tumours, polyps, infection, foreign bodies or upper airway trauma [14]. [2,15,16], and when used by both inexperienced and novice users [17,18].…”

“…[2,15,16], and when used by both inexperienced and novice users [17,18]. The Airtraq also improved the intubation difficulty score and easy of use in patients with normal airways [14]. The blade of the Airtraq consists of two side-by-side channels.…”

Use of lighted stylets to facilitate insertion of double-lumen endobronchial tubes in patients with difficult airway anatomy

“…The principle of this approach is placement of the ETT containing the lighted stylet in the oropharynx and advancement of the ETT over the stylet into the trachea when a bright red glow is detected in the central portion of the neck near the cricoid cartilage [7], the brightest illumination indicating position of the ETT either in the trachea or at the glottic opening. Double-lumen endobronchial tube placement can be challenging, even in patients with normal airway anatomy, because of their larger size and unique configuration, and can be especially difficult to place in patients with abnormal airways.…”

“…Recommended solutions to the management of DLT placement in patients with a difficult airway include fiberoptic-assisted DLT placement [1,2], single-lumen endotracheal tube (ETT) placement and use of a bronchial blocker [3,4], single-lumen ETT placement followed by the use of an airway exchange catheter to guide replacement with a DLT [5], fiberoptic placement of a Univent tube 5, and endobronchial placement of a single-lumen ETT [6]. Use of a lighted stylet to facilitate single-lumen ETT placement in patients with normal and abnormal airway anatomy has been extensively reported [7,8], and letters to the editor have also described the use of a lighted stylet to place a DLT [9,10]. We describe our experience with a lighted stylet for placement of a DLT in patients with both normal and abnormal airway anatomy and suggest this as an additional approach to the patient with a difficult airway who requires lung isolation with a DLT.…”

The Development of Techniques for Airway Management

“…It consisted of two pieces, a reusable handle with an internal light source and a disposable, retractable stylet providing rigidity during insertion but flexibility during withdrawal [ 93 -95 ]. Several other lighted stylets have since been introduced and removed from clinical practice [ 94 ]. However, limited transmission of light especially in obese patients with thick necks remains as a limitation of the technique.…”