[Combined use of the GlideScope and fiberoptic bronchoscope for tracheal intubation in a patient with difficult airway].

We report a case of successful tracheal intubation of a double-lumen tube with combined use of a videolaryngoscope (GlideScope) and a fiberoptic bronchoscope, in a patient with difficult airway, in whom intubation using the GlideScope had failed. A 71-year-old man with lung cancer was scheduled for the middle lobe lobectomy under general anesthesia. Anesthesia was induced with propofol, fentanyl and sevoflurane, and after confirmation of adequate ventilation through a facemask, rocuronium was given. The GlideScope was inserted at first, but it was difficult to see the glottis (Cormack-Lehane classification III) and tracheal intubation of a 37 Fr double-lumen tube failed. While the GlideScope was in place to obtain a view near the glottis, a fiberoptic bronchoscope (passed through the double-lumen tube) was insertd into the trachea, and the tube was passed over the scope into the trachea. We believe that, when tracheal intubation of a double-lumen tube using a videolaryngoscope or fiberoptic bronchoscope is difficult, their combined use may be useful in a patient with difficult airway.