[Successful nasal intubation using airway scope with gum elastic bougie in a case of difficult airway]

AWS (Airway Scope, Pentax, Tokyo), a new videolaryngoscope, was originally designed to facilitate oral laryngoscopy and tracheal intubation. We describe a successful case of nasal intubation with a combination of AWS and GEB (gum elastic bougie). A 50-year-old man with a past history of difficult intubation was scheduled to undergo subtotal esophagectomy. As the patient was scheduled to be ventilated overnight after the operation in the intensive care unit, nasal intubation with a combination of AWS and GEB was planed. Anesthesia was induced with intravenous propofol 100 mg, fentanyl 200 microg and vecuronium 7 mg and endotracheal tube was inserted through the nostril. Oral insertion of AWS showed full view of the glottis and nasal insertion of GEB was easily advanced into the trachea through an endotracheal tube, allowing tracheal intubation while utilizing GEB as a stylet. No complication occured in this case. In conclusion, nasal intubation using AWS combination with GEB is useful for patients with difficult airways and is easy to perform.