Soft palate trauma induced during GlideScope intubation

Simultaneous en bloc endotracheal tube insertion with GlideScope® Titanium™ video laryngoscope use: a randomized-controlled trial

“…The median [IQR] ease of intubation using the 100-mm VAS was 11 [9][10][11][12][13][14][15][16][17][18][19][20][21] mm with the en bloc technique and 15 [11][12][13][14][15][16][17][18][19][20][21][22][23][24] mm with the standard technique (difference in medians, 4 mm; 95% CI, -2 to 8; P = 0.19). There was also no statistically significant difference between the groups for number of intubation attempts, laryngoscopic grade, or incidence of oropharyngeal bleeding, as shown in Table 2.…”

“…There was no observed trauma [9][10][11][12][13][14][15] in either group, and while the potential benefit of visualizing the ETT for its entire path through the pharynx to the trachea is selfevident, this study was not powered to evaluate this outcome. Considering the complication rate associated with GlideScope intubation, a much larger sample size would be required to show difference in these lowprobability events.…”

“…The first is rare airway trauma to the palate and/or tonsillar pillars. [9][10][11][12][13][14][15] With standard use, the GlideScope is inserted into the pharynx and a glottic view obtained, after which the endotracheal tube (ETT) is advanced. While the ETT can be visualized directly in the oral cavity, and subsequently at the glottic aperture via the GlideScope screen, a portion of the ETT advancement is done blindly, and this may contribute to airway trauma.…”

“…While the ETT can be visualized directly in the oral cavity, and subsequently at the glottic aperture via the GlideScope screen, a portion of the ETT advancement is done blindly, and this may contribute to airway trauma. 9,12,13,15 The second observation is that it is occasionally difficult to advance the ETT to a position at the glottic aperture visible on the monitor, [16][17][18] even with a good view 6 of the glottis.…”

“…Results The median [interquartile range (IQR)] intubation time was 36 [31][32][33][34][35][36][37][38][39][40][41][42] sec with the en bloc technique vs 41 [37-50] sec with the standard technique (difference in medians, 5 sec; 95% confidence interval [CI], 2 to 11; P = 0.008). The median [IQR] ease of intubation VAS was 11 [9][10][11][12][13][14][15][16][17][18][19][20][21] mm with the en bloc technique, and 15 [11][12][13][14][15][16][17][18][19][20][21][22][23][24] mm with the standard technique (difference in medians, 4 mm; 95% CI, -2 to 8; P = 0.19). Laryngoscopic grade and number of intubation attempts were similar between the groups; there was no oropharyngeal trauma noted.…”