Modified long Trachlight wand for a double-lumen endobronchial tube

Double-lumen tube tracheal intubation using a rigid video-stylet: a randomized controlled comparison with the Macintosh laryngoscope

“…1 3 However, replacing a single-lumen tube using an airway exchange catheter with DLT carries a risk of unexpected airway loss, some difficulties, extended intubation time, and a chance of airway trauma. 1 Therefore, diverse modified DLT placement strategies for the direct placement of a DLT have been reported, such as the use of a lighted stylet inserted into a DLT with excision of 2-2.5 cm of both proximal connectors, 9 10 a single longer Trachlight wand consisting of two combined Trachlight wands, 21 and a Trachlight combined with a DLT through a 2 cm longitudinal incision made in the bronchial lumen of a DLT. 22 In addition, a Bonfils intubation fibrescope has been also used with DLTs of size 37 Fr or larger after shortening both proximal connectors to a length of 38.5 cm.…”

“…Induction of anaesthesia was standardized using i.v. lidocaine 40 mg, propofol 1.5 mg kg 21 rocuronium 1.0 mg kg 21 was used to facilitate tracheal intubation. Three minutes after rocuronium injection and after confirmation of full neuromuscular relaxation with a nerve stimulator, Cormack and Lehane (C and L) grading was performed in all patients using a Macintosh laryngoscope in the sniffing position.…”

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

“…Our stylets share some of these limitations, as the Surch-Lite is too large for DLTs less than 39 Fr in diameter. Watanabe [10] described a modification of the Trachlight that involves dismantling of two wands and rewiring of the electrical fibers to increase the length of the stylet. Although potentially useful, it appears cumbersome and complex to create, sacrifices two wands, and can only narrowly pass through a 37-Fr Broncho-Cath.…”

“…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.…”

Equipment to Manage a Difficult Airway during Anaesthesia

“…Combined techniques have been described with the cLMA 146 , ILMA 56 , Bullard™ 147 and retrograde intubation 148 . The Trachlight has been used to aid double-lumen tube insertion 149 , and topicalisation of the airway prior to awake intubation 150 . It is suitable for patients with unstable cervical spines 151 and in patients with and without muscle relaxant 152 .…”