A study to evaluate nasotracheal intubation using Airtraq laryngoscope with a bougie and without a bougie

Airtraq has been found to be useful in improving the view of the glottis. However, directing the tube tip into the glottis can be challenging during nasotracheal intubation. This problem gets resolved if the bougie is placed first. The present study was conducted for the evaluation of nasotracheal intubation using a nasal Airtraq laryngoscope with and without a bougie.

Fifty patients of either gender, aged between 18 and 60 years, who belonged to the American Society of Anesthesiologists physical status (PS) I or II, requiring nasotracheal intubation were included. In group I (number (n) = 25), nasotracheal intubation was performed with a bougie, and in group II (n = 25), it was performed without a bougie. The primary objective was a comparison of the time taken to achieve successful nasotracheal intubation. Secondary objectives were ease of intubation and additional manoeuvres required for intubation.

The mean (± standard deviation) for time for intubation in group I was 59.24 ± 9.98 s and that in group II was 41.00 ± 4.23 s (P = 0.001). Two patients (8%) in group I and ten patients (40%) in group II required additional manoeuvres for intubation (P = 0.008). Twenty-three patients (92%) in group I and 15 patients (60%) in group II had easy intubation (P = 0.030). In group I, no patient had trauma, whereas, in group II, four patients (16%) had trauma (P = 0.030) during intubation.

The time taken for nasotracheal intubation using an Airtraq laryngoscope was more with the use of a bougie as compared to the non-bougie technique. However, bougie-guided intubation was easier with less requirement of additional manoeuvres. In addition, trauma was also significantly less with the bougie technique.