Awake Video Laryngoscopy–Assisted Intubation of Morbidly Obese Patients

Morbidly obese patients often are intubated “awake” due to inherent difficulties in intubation and use of a bag-valve mask. Direct laryngoscopes or flexible fiber-optic bronchoscopes have been used, but video laryngoscopes have not been fully evaluated for this purpose. In a prospective study, researchers evaluated use of a GlideScope to perform awake intubation in 50 morbidly obese (body-mass index, >40 kg/ m²) patients undergoing bariatric surgery who each had at least two potential difficult airway predictors (modified Mallampati score ≥3, presence of teeth, history of sleep apnea, mouth opening or hyomental distance <3 cm). All patients received atomized 2% lidocaine topical anesthesia; additional topical anesthesia or sedation was admi…