A trial for smooth intubation of obese patients by lubricating the Glidescope® blade: a prospective randomized controlled trial

Abstract

Background: Obese patients often pose endotracheal intubation (ETI) and/or ventilation difficulties, when compared to non-obese patients. Reducing the duration of intubation helps to prevent the associated respiratory and hemodynamic complications. We evaluated the effect of lubricating the undersurface of the Glidescope® blade at the intubation time as well as other associated drawbacks while intubating obese patients.

Methodology: A total of 54 adult patients undergoing elective bariatric surgery requiring general anesthesia and oral ETI were included in this study. Out of these 27 patients were included in Group L, in which the underside of the GlideScope® blade used for intubation was lubricated by soluble lidocaine jelly, taking care not to touch the camera or the source of light. The rest of the patients (n = 27) were included in Group C (control group). In the control group, the patients were handled with the same technique but using a standard non-lubricated blade. Intubation time, staring from blade introduction in the mouth to tube entrance into the glottis was registered.

Results: There was a statistically significant difference in intubation outcomes between the Group L and the Group C. The mean intubation times were 15.15 ± 4.24 sec vs. 23.98 ± 5.94 sec (P = 0.0001) for the Group L and C respectively.

Conclusion: Lubricating the blade can be an independent factor that can reduce the time of tracheal intubation, such as smoothening the insertion of the blade during tracheal intubation and preventing the tongue from being curled up. The maneuver can also reduce bleeding during the tracheal intubation due to dry tongue.

Abbreviations: ETI: endotracheal intubation; ETT; endotracheal tube;

Keywords: Blade; Endotracheal Intubation; GlideScope; Obesity

Citation: Barsoom Ayoub SN, Rabah Alharbi RS. A trial for smooth intubation of obese patients by lubricating the Glidescope® blade: a prospective randomized controlled trial. Anaesth. pain intensive care 2024;28(2):254−258; DOI: 10.35975/apic.v28i2.2428

Received: December 09, 2023; Reviewed: February 16, 2024; Accepted: February 16, 2024