Abstract :
Background and Aims: Nasotracheal intubation (NTI) is a common technique in airway management, particularly for oropharyngeal and maxillofacial surgeries, but it is often associated with nasopharyngeal trauma. The use of a gum elastic bougie, a flexible device, may mitigate this complication and facilitate NTI. This study aimed to compare videolaryngoscopic-assisted bougie-guided and non-bougie-guided nasotracheal intubation (NTI) in terms of the incidence and severity of nasopharyngeal bleeding, intubation time, the need for Magill forceps assistance, and external laryngeal manipulation.
Materials and Methods: This prospective, randomized controlled trial was conducted on 90 adult patients undergoing elective surgeries requiring NTI at a tertiary care hospital. Patients were randomly assigned into two groups using a closed-envelope technique: the bougie-guided group (Group B) and the non-bougie-guided group (Group NB). In Group B, NTI was performed by first inserting the gum elastic bougie under videolaryngoscopic guidance, followed by railroaded endotracheal tube (ETT) placement. In Group NB, the ETT was inserted directly under videolaryngoscopic guidance. Nasopharyngeal bleeding was assessed at 1 and 5 minutes post-intubation, and the time required for intubation was recorded.
Results: Incidence of nasopharyngeal bleeding at 1 minute was 24.4% in group B versus 82.2% in Group NB (p
Conclusion: Bougie-guided nasotracheal intubation significantly reduces the incidence and severity of nasopharyngeal bleeding and decreases intubation time in adult patients. This technique offers a safer and more efficient approach to NTI.
Keyword :
Nasal intubation, Nasopharyngeal trauma, Gum elastic bougie.