Abstract

We would like to report a fracture of a GlideScope® videolaryngoscope (Cobalt GVL® Stat) blade (Verathon Inc., Bothell, WA, USA) during an attempted intubation. A 39-year-old woman presented for elective sleeve gastroplasty. We expected a difficult intubation based on our pre-operative airway examination. As the patient refused awake fibreoptic intubation, we planned electively to use the GlideScope. Following induction of general anaesthesia, we inserted the GlideScope into the middle part of the mouth and laryngoscopy revealed a Cormack and Lehane grade-3 view. We repositioned the GlideScope and applied additional force to the distal part of the blade. At that moment, the distal segment of the blade broke off (Fig. 3). An intubating laryngeal mask airway (LMA North America, Inc., San Diego, CA) facilitated successful ventilation and intubation. We noted high inflation pressures and a chest roentgenogram revealed left lung atelectasis. We cancelled the surgical procedure and transferred the patient to our post-anaesthesia care unit, where she recovered uneventfully. The planned surgery was performed one month later, with awake fibreoptic tracheal intubation. Broken GlideScope videolaryngoscope blade. We could find only one report of a GlideScope disposable blade fracture [1]. In that case, because of limited mouth opening, the blade was inserted into the right side of the mouth and oriented obliquely, rather than midline as is recommended. During midline re-orientation of the blade, the distal flat tip pushed against the tongue and broke off. The authors attributed the blade fracture to the torsional force applied during the oblique insertion and rotation. We were able to insert the blade easily in the midline; the fracture occurred during application of an upward force during repositioning of the blade, but at the same location as in the previously reported case. We speculate that the blade fracture in our case was caused either by the excessive force applied to the blade or due to a manufacturing defect. Despite our isolated incident, though, we highly encourage the use of the GlideScope videolaryngoscope for routine and difficult intubations.

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