Complications associated with the use of the GlideScope® videolaryngoscope

Case Reports/Case Series

Abstract

Purpose

Tw o cases are presented wherein the GlideScope® videolaryngoscope (GVL) facilitated laryngeal exposure and successful endotracheal intubation, but resulted in pharyngeal injury.

Clinical features

GlideScope® videolaryngoscopy was performed in two female patients, whose airways were anticipated to present difficulties for direct laryngoscopy. In the first case, following induction of anesthesia, moderate difficulty was encountered in directing the endotracheal tube (ETT) into the patient’s larynx. In the second case, minimal difficulty with the GVL was experienced, and no problems were identified with airway instrumentation until the drapes covering the patient’s face were removed. In both instances, the ETT had passed through the right palatopharyngeal arch, requiring suturing in the first patient, and electrocautery in the second patient.

Conclusion

There have been no previously published reports of injuries related to GlideScope® laryngoscopy, but perforation of the palatopharyngeal arch occurring in two patients demonstrates a rare but potentially important complication of the GVL. Strategies to minimize this complication are considered.

Complications suite à l’utilisation du vidéolaryngoscope GlideScope®

Résumé

Objectif

Sont présentés deux cas dans lesquels l’utilisation du vidéolaryngoscope GlideScope® (GVL) a facilité l’exposition laryngée et l’intubation endotrachéale, mais a eu pour conséquence un traumatisme pharyngé.

Eléments cliniques

La vidéolaryngoscopie avec le GlideScope® a été effectuée sur deux patientes chez qui on anticipait une laryngoscopie directe difficile. Dans le premier cas, suite à l’induction de l’anesthésie, une difficulté modérée a été rencontrée à orienter la sonde endotrachéale (SET) vers le larynx de la patiente. Dans le second cas, peu de difficultés ont été rencontrées avec le GVL, et aucun probléme n’a été identifié lors de l’instrumentation des voies aériennes jusqu’à ce que les champs qui couvraient le visage de la patiente soient enlevés. Dans les deux cas, la SET avait traversé l’arche palato-pharyngée droite, nécessitant des points de suture chez la premiére patiente et une électrocautérisation chez la seconde.

Conclusion

Il n’existe pas d’articles déjà publiés rapportant des blessures suite à une laryngoscopie avec le GlideScope®; toutefois, une perforation de l’arche palato-pharyngale, survenue chez deux patientes, illustre une complication rare du GVL, mais potentiellement importante. Nous présentons certaines stratégies pour diminuer la gravité de cette complication.

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Copyright information

© Canadian Anesthesiologists 2007

Authors and Affiliations

  1. 1.Department of AnesthesiaUniversity of Toronto, Toronto General HospitalTorontoCanada

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