Comparison of two methods of gum elastic bougie aided endotracheal intubation using Airtraq (R) video laryngoscope

This study was conducted to compare two methods of gum elastic bougie (GEB) aided endotracheal intubation using Airtraq (R) video laryngoscope. Materials and method: In this prospective study, sixty patients undergoing elective surgery under general anaesthesia were randomly allocated into two groups. In Group P, Airtraq (R) was preloaded with endotracheal tube (ETT) with the GEB placed inside it up to the tip and the entire assembly is passed en bloc into the mouth. On visualisation of the glottis, the GEB is initially advanced across the glottis followed by railroading the ETT into the trachea. In Group S, GEB was introduced separately from the side after visualisation of the glottis using Airtraq (R), followed by railroading the ETT over the GEB. Time taken for successful insertion of GEB, ease of insertion of GEB, time taken and number of attempts at endotracheal intubation were noted. Results: As the data for time taken for GEB insertion were skewed, the statistical analysis was done using Mann-Whitney U test and median, 25th and 75th percentile values were calculated. Time taken for GEB insertion and endotracheal intubation was found to be shorter in Group P than in Group S, both the results being statistically significant. The time taken for GEB insertion was 7.71 seconds (median) in Group P and 20.44 seconds (median) in Group S, whereas time taken for endotracheal intubation was 14.68 +/- 0.913 seconds vs. 29.10 +/- 1.83 in Group P and Group S respectively. Conclusion: The use of GEB preloaded into the ETT or insertion of the same from the side of the mouth while using Airtraq (R) proves to be a clinically effective alternative to achieve successful endotracheal intubation. Time taken to achieve successful endotracheal intubation is shorter if the GEB is preloaded into the endotracheal tube. Additional manoeuvres like external laryngeal manipulation will help in GEB advancement especially when it is inserted from the side of the mouth using Airtraq (R)