Lightwand intubation using the Trachlight™: a brief review of current knowledge

  • Felice AgròEmail author
  • Orlando R. Hung
  • Rita Cataldo
  • Massimiliano Carassiti
  • Stefano Gherardi
Cardiothoracic Anesthesia, Respiration and Airway



About 1% to 3% of laryngoscopic intubations can be difficult or impossible. Light-guided intubation has been proven to be an effective, safe, and simple technique. This article reviews current knowledge about the newer version lightwand: the Trachlight™ (TL).


To determine its clinical utility and limitations, we reviewed the current literature (book and journal articles) on the TL since its introduction in 1995.

Principal findings

TL has been shown to be useful both in oral and nasal intubation for patients with difficult airways. It may also be useful in “emergency” situations or when direct laryngoscopy or fiberoptic endoscopy is not effective, such as with patients who have copious secretions or blood in the oropharynx. TL can also be used for tracheal intubation in conjunction with other devices (laryngeal mask airway -LMA-, intubating LMA, direct laryngoscopy). However, TL should be avoided in patients with tumours, infections, trauma or foreign bodies in the upper airway.


Based on the clinical reports available, the TL has proven to be a useful option for tracheal intubation. In addition, the device can also be used together with other intubating devices, such as the intubating LMA and the laryngoscope, to improve intubating success rates. A clear understanding of the principle of transillumination of the TL, and an appreciation of its indications, contraindications, and limitations, will improve the effectiveness of the device as well as reducing the likelihood of complications. Finally, regular practice with the TL with routine surgical patients requiring tracheal intubation will further improve intubation success rates.


Tracheal Intubation Laryngeal Mask Airway Difficult Airway Direct Laryngoscopy Anterior Neck 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Intubation avec le stylet lumineux Trachlight™: un aperçu des connaissances actuelles



La fréquence d’intubation difficile ou impossible varie de 1% à 3%. L’intubation trachéale avec le Trachlight™ (TL) représente une technique efficace, sûre et simple.

Dans cet article nous voulons réviser les connaissances actuelles sur le stylet lumineux TL.


Pour déterminer les applications et les limitations du TL, nous avons révisé la littérature (livres ou revues) sur le TL à partir de son introduction en 1995.


Le TL permet une intubation oro-ou naso-trachéale dans différentes situations d’intubation difficile. Cette technique d’intubation avec le TL peut également être utile dans des situations d’urgence ou quand l’intubation trachéale avec le bronchoscope n’est pas indiquée, comme chez les patients qui présentent des sécrétions abondantes ou du sang dans l’oropharynx.

Le TL peut également être utilisé pour l’intubation trachéale en même temps que d’autres dispositifs (masque laryngé, masque laryngé pour intubation, laryngoscopie directe). Cependant l’usage du TL devrait être évité chez les patients présentant une tumeur, une infection, un traumatisme ou un corps étranger dans les voies aériennes.


Selon les rapports cliniques à notre disposition, nous pouvons affirmer que le TL représente une solution de remplacement utile à la laryngoscopie traditionnelle. Le TL peut également être utilisé avec d’autre dispositifs comme le masque laryngé et la laryngoscopie directe pour augmenter le taux de réussite de l’intubation trachéale.

En conclusion, la pratique régulière avec le TL et une connaissance de ses indications, contre-indications et limitations, peut améliorer l’efficacité du dispositif et réduire la probabilité de complications.


  1. 1.
    Hung OR, Stewart RD. Illuminating stylet (lightwand).In: Benumof JL (Ed.). Airway Management, Mosby, 1996: 342–52.Google Scholar
  2. 2.
    Hung OR, Stewart RD. Lightwand intubation: I — A new ligthwand device. Can J Anaesth 1995; 42: 820–5.PubMedGoogle Scholar
  3. 3.
    Hung OR, Pytka S, Morris I, Murphy M, Stewart RD. Lightwand intubation: II — Clinical trial of a new ligthwand for tracheal intubation in patients with difficult airways. Can J Anaesth 1995; 42: 826–30.PubMedGoogle Scholar
  4. 4.
    Hung OR, Pytka S, Morris, I et al. Clinical trial of a new lightwand device (Trachlight) to intubate the trachea. Anesthesiology 1995; 83: 509–14.PubMedCrossRefGoogle Scholar
  5. 5.
    Hung OR, Al-Qatari M Light-guided retrograde intubation. Can J Anaesth 1997; 44: 877–82.PubMedGoogle Scholar
  6. 6.
    Nishiyama T, Matsukawa T, Hanaoka K. Safety of a new lightwand device (Trachlight™): temperature and histopathological study. Anesth Analg 1998; 87: 717–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Fisher QA, Tunkel DE. Lightwand intubation of infants and children. J Clin Anesth 1997; 9: 275–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Ovassapian A, Meyer RM. Airway management.In. Longnecker JH, Tinker JH, Morgan GE, (Eds.). Principles and Practice of Anesthesiology 2nd ed. Mosby, 1998: 1064–99.Google Scholar
  9. 9.
    Iseki K, Murakawa M, Tase C, Otsuki M. Use of a modified lightwand for nasal intubation (Letter). Anesthesiology 1999; 90: 635.PubMedCrossRefGoogle Scholar
  10. 10.
    Asai F. Endotrol tube for blind nasotracheal intubation (Letter). Anaesthesia 1996; 50: 507.CrossRefGoogle Scholar
  11. 11.
    Agrò F, Brimacombe J, Marchionni L, Carassiti M, Cataldo R. Nasal intubation with the Trachlight (Letter). Can J Anesth 1999; 46: 907–8.PubMedGoogle Scholar
  12. 12.
    Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985; 32: 429–4.PubMedCrossRefGoogle Scholar
  13. 13.
    Iseki K, Watanabe K, Iwama H. Use of the Trachlight for intubation in the Pierre-Robin syndrome (Letter). Anaesthesia 1997; 52: 801–2.PubMedGoogle Scholar
  14. 14.
    Agrb F, Brimacombe J, Carassiti M, Morelli A, Giampalmo M, Cataldo R. Use of a lighted stylet for intubation via the laryngeal mask airway. Can J Anaesth 1998; 45: 556–60.CrossRefGoogle Scholar
  15. 15.
    Asai T, Latto IP. Use of the lighted stylet for tracheal intubation via the laryngeal mask airway (Letter). Br J Anaesth 1995; 75: 503–4.PubMedGoogle Scholar
  16. 16.
    Asai T, Oldham T, Latto IP. Unexpected difficulty in the lighted stylet-aided tracheal intubation via the laryngeal mask (Letter). Br J Anaesth 1997; 78: 111–2.PubMedGoogle Scholar
  17. 17.
    Agrò F, Brimacombe J, Carasiti M, Morelli A, Giampalmo M, Cataldo R. Lighted stylet as an aid to blind tracheal intubation via the LMA (Letter). J Clin Anesth 1998; 10: 263–4.PubMedCrossRefGoogle Scholar
  18. 18.
    Hung OR. Light-guided tracheal intubation using a new intubating LMA (Fastrach). Anesthesiology 1998; 89: A553(abstract).CrossRefGoogle Scholar
  19. 19.
    Biehl JW, Bourke DL. Use of the lighted stylet to aid direct laryngoscopy (Letter). Anesthesiology 1997; 86: 1012.PubMedCrossRefGoogle Scholar
  20. 20.
    Gataure PS, Vaughan RS, Latto IP. Simulated difficult intubation. Comparison of the gum elastic bougie and the stylet. Anaesthesia 1996; 51: 935–8.PubMedCrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists 2001

Authors and Affiliations

  • Felice Agrò
    • 1
    Email author
  • Orlando R. Hung
    • 2
  • Rita Cataldo
    • 1
  • Massimiliano Carassiti
    • 1
  • Stefano Gherardi
    • 1
  1. 1.Department of AnaesthesiaUniversity School of Medicine Campus Bio-MedicoRomeItaly
  2. 2.Department of Anaesthesia and PhamacologyDalhousie UniversityHalifaxCanada

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