SIMULATED DIFFICULT INTUBATION - COMPARISON OF THE GUM ELASTIC BOUGIEAND 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 l aryngoscopic assessment, as described by Cormack and Lehane, was made in 100 patients. A Grade 3 view was then simulated. In the Bougie Firs t Group (50 patients) two attempts were made to pass a gum elastic bou gie and a tracheal tube into the trachea. If these two attempts were n ot successful, two further attempts at intubation were allowed with a stylet placed in the tracheal tube. In the Stylet First Group (50 pati ents) the order was reversed. After two attempts the tube was correctl y placed in the trachea in 96% of cases in the Bougie First Group comp ared to only 66% of cases in the Stylet First Group (p<0.001). We reco mmend that a gum elastic bougie should be readily available and that a naesthetists should use it in preference to a stylet whenever a good r eview of the glottis is not immediately available.