Comparing Three Video Laryngoscopes for Intubation of Obese Patients

Some video laryngoscope manufacturers recommend routine use of a stylet to shape the endotracheal tube for optimal insertion through the glottis, but, given that palatal perforation has been reported in this setting, are stylets always required? Researchers in the Netherlands randomized 150 obese (body-mass index, >35 kg/m²) adult elective anesthesia patients to undergo standard direct laryngoscopy to assess laryngoscopic view, followed by tracheal intubation performed without a stylet with one of three video laryngoscopes: GlideScope Ranger, Storz V-MAC, or McGrath. If intubation was not successful after two attempts (defined as an approach to the glottic entrance), then a rigid stylet was used. All intubations were performed by anesthesio…