The videolaryngoscope is less traumatic than the classic laryngoscope for a difficult airway in an obese patient

The videolaryngoscope is less traumatic than the classic laryngoscope for a difficult airway in an obese patient

Maassen, R.
Lee, R.
Van Zundert, A.
Cooper, R.

Mechanical, Maritime and Materials Engineering

Biomechanical Engineering

2009-08-14

This report describes the anesthetic management of an obese patient with a difficult airway and the merits of videolaryngoscopy, specifically in terms of the reduced risk of dental damage during intubation. A 49-year-old woman (body mass index; BMI, 36 kg·m?2), was scheduled to undergo an elective laparoscopic cholecystectomy because of cholelithiasis. Based upon the obesity of the patient and preoperative metrics (Mallampati grade IV; interdental distance of 2.9 cm; thyromental distance, 5.5 cm) a difficult airway was anticipated. Classic direct laryngoscopy using a Macintosh blade size IV failed, despite three intubation attempts—each resulting in a Cormack-Lehane grade IV view. Intubation using a video-assisted Macintosh laryngoscope (V-Mac; Karl Storz, Tuttlingen, Germany) was successful upon the first attempt. The maximum force exerted on the patient’s maxillary incisors was 61 N by direct laryngoscopy and 7.6 N using the indirect videolaryngoscope, both using a Macintosh blade.

General anesthesia
Intubation
Videolaryngoscopy
Difficult airway
Force measurement

http://resolver.tudelft.nl/uuid:255f7330-a144-45f7-9d39-4fc861d5f680

Springer

1438-8359

Journal of Anesthesia, 23 (3)

Institutional Repository

journal article

(c) 2009 Springer; JSA