Simulated difficult intubation. Comparison of the gum elastic bougie and the stylet.
A randomised study was carried out to compare the efficacy of the gum elastic bougie and the stylet in a simulated difficult intubation. A laryngoscopic assessment, as described by Cormack and Lehane, was made in 100 patients. A Grade 3 view was then simulated. In the Bougie First Group (50 patients) two attempts were made to pass a gum elastic bougie and a tracheal tube into the trachea. If these first two attempts were not successful, two further attempts at intubation were allowed with a stylet placed in the tracheal tube. In the Stylet First Group (50 patients) the order was reversed. After two attempts the tube was correctly placed in the trachea in 96% of cases in the Bougie First Group compared to only 66% of cases in the Stylet First Group (p < 0.001). We recommend that a gum elastic bougie should be readily available and that anaesthetists should use it in preference to a stylet whenever a good view of the glottis is not immediately available.
Gataure
P S
PS
Department of Anaesthetics, Princess of Wales Hospital, Bridgend, Mid-Glamorgan.
Vaughan
R S
RS
Latto
I P
IP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D004947:Esophagus; D005260:Female; D005547:Foreign Bodies / Q000209:etiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D013997:Time Factors