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Background: Although Lightwand and Glidescope have both shown high success rates for intubation, there has been noconfirmation as to which device is most effective for difficult endotracheal intubation. We compared the Glidescope andLightwand devices in terms of duration of intubation and success rate at the first attempt in a simulated difficult airwaysituation. Methods: Fifty-eight patients were randomized to undergo tracheal intubation with either the Glidescope (Glidescopegroup, n = 29) or the Lightwand (Lightwand group, n = 29). All patients were fitted with a semi-hard cervical collar inorder to simulate a difficult airway, and intubation was attempted with the assigned airway device. The data collected includedthe rate of successful endotracheal intubation, the number of attempts required, the duration of the intubation, aswell as the interincisor distance, hemodynamic variables, and adverse effects. Results: There was no difference between Glidescope group (92.6%) and Lightwand group (96.4%) in terms of successrate for the first attempt at intubation. The duration of successful intubation for the first tracheal intubation attempt wassignificantly longer in Glidescope group than in Lightwand group (46.9 sec vs 29.5 sec, P = 0.001). All intubations werecompleted successfully within two intubation attempts. The incidence of hypertension was significantly higher in Glidescopegroup than in Lightwand group (51.9% vs 17.9%, P = 0.008). Conclusions: In a simulated difficult airway situation, endotracheal intubation using Lightwand yielded a shorter durationof intubation and lower incidence of hypertension than when using Glidescope.

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