Successful tracheal intubation in a patient with trismus using the X blade and McGrath videolaryngoscope

Summary The McGrath® MAC videolaryngoscope is designed for difficult airways and several standard blades are available. In July 2014, the X blade, with a more acute anterior curvature and slimmer profile than standard blades, entered the Japanese market. We report a case of successful tracheal intubation in a patient with trismus using the X blade. A 59‐yr‐old female presented for right upper lobectomy due to suspected lung cancer. After induction of general anaesthesia, mouth opening was limited to only 15 mm, possibly due to a temporomandibular disorder. We were able to insert the X blade without difficulty and visualise the glottis. Advancing the tracheal tube through the glottis was difficult, so we inserted a catheter through the tracheal tube. We could then advance the tracheal tube over the catheter into the trachea. Combination of the X blade and an introducer may be an option when faced with a difficult airway, especially due to trismus.