Awake Face-to-Face Laryngoscopy: GlideScope vs. Fiber-Optic Scope

When difficult intubation is anticipated in a spontaneously breathing patient, “awake” intubation without use of a neuromuscular blocking agent is indicated. This is traditionally accomplished with flexible fiber-optic intubation, which is convenient to perform in seated patients. In a randomized crossover study of 23 healthy awake seated volunteers, these authors compared visualization of the larynx with GlideScope video laryngoscopy and flexible fiber-optic laryngoscopy. Operators were two emergency medicine residents and two EM attending physicians, each of whom had used these techniques <10 times.

Before undergoing laryngoscopy, patients received nebulized 5% lidocaine followed by atomized 4% lidocaine sprayed into the nose and oropharyn…