Fracture of laryngoscope blade

Abstract

To the editorWe present a laryngoscope blade fracture which occurred during an endotracheal intubation.A 55-year-old woman with opacity of the vitreous was scheduled for vitrectomy. Anesthesia was induced with i.v. 200mg of thiamylal, and ventilation was assisted using nitrous oxide (66%) and isoflurane (2%) in oxygen. After i.v. 6rag of vecuronium was administered, an attempt was made to intubate the trachea using a laryngoscope with a #3 blade. When the blade was inserted into the vallecula and the laryngoscope was pulled forward and upward for orotracheal intubation, the blade abruptly fractured where the hook-on base was attached to the web (Fig. 1). Fortunately, the teeth and soft tissues of the oral and perioral area were not damaged by the blade fragment. The trachea was immediately intubated using another laryngoscope, and the surgery was performed uneventfully.Since laryngoscope malfunction is a frequent problem [1], the user should keep at least two laryngoscopes on hand, each fitted with the type of blade the user anticipates will be best for the patient, and the light of each laryngoscope should be checked for adequate intensity. We had preoperatively confirmed that the size of the blade was suitable for the patient and that the light had adequate intensity; we had not noticed any looseness between the base and the web of the blade. Thus, this fracture appears to have been induced by the force of orotracheal intubation in the present patient. Fig, 1. Laryngoscope blade fracture between hook-on base and web Address correspondence to: M. Kawamata