A Comparison of Two Tracheal Intubation Techniques with Trachlight™ and Fastrach™ in Patients with Cervical Spine Disorders

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Abstract
Optimal airway management strategies in patients with an unstable cervical spine remain controversial. A newly designed lightwand device (Trachlight™) or an intubating laryngeal mask (Fastrach™) may avoid hyperextension of the neck. However, there are few objective data that guide us in selecting the appropriate devices. We conducted a prospective randomized study in 148 patients who received general anesthesia for whom the operations were related to the clinical and/or radiographic evidence of cervical abnormality. Trachlight™ or Fastrach™ was used for tracheal intubation with the head and neck held in a neutral position. In the Trachlight™ group, intubation was successful at the first attempt in 67 of 74 (90.5%) cases and at the second attempt in 5 (6.8%) cases. In contrast, in the Fastrach™ group, 54 of 74 (73.0%) patients were intubated within our protocol. The mean time for successful tracheal intubation at the first attempt was significantly shorter in the Trachlight™ group than in the Fastrach™ group. The Trachlight™ may be more advantageous for orotracheal intubation in patients with cervical spine disorders than the Fastrach™ with respect to reliability, rapidity, and safety.