Abrons RO, et al. - This study entailed an assessment of a novel technique for routine asleep (i.e. post-induction) nasotracheal intubation using a bougie (‘bougie technique’), which uses a nasopharyngeal airway to guide a paediatric bougie nasotracheally for use as a Seldinger tracheal intubation guide. Findings revealed that in addition to affording success rates equivalent to that achieved with the conventional technique, nasal intubation over a bougie also provided a marked attenuation in both the incidence and severity of nasopharyngeal trauma, as well as the need for the use of Magill forceps.

Methods

• Researchers randomly assigned 257 older children (> 8 years) and adults to videolaryngoscopy-assisted nasotracheal intubation using either the conventional or the bougie technique.
• The hypothesis was that the bougie technique would result in less nasopharyngeal trauma.

Results

• Findings demonstrated that the bougie technique was associated with significantly less nasopharyngeal bleeding than the conventional technique at both 60–90 s (55% vs. 68%; p = 0.033) and 5 min (51% vs. 70%; p = 0.002).
• Researchers observed that the severity of bleeding was also significantly less with the bougie technique, with an OR for active bleeding of 0.42 (95%CI 0.20–0.87; p = 0.020) at 60–90 s and 0.15 (95%CI 0.06–0.37; p < 0.0001) at 5 min.
• In addition, they noted that Magill forceps were needed significantly less often with the bougie technique (9% vs. 28%, p = 0.0001) and there was no difference in first attempt and overall success rates between the two techniques (p = 0.133 and p = 0.750, respectively).