COMPARISON OF THE OUTCOME OF NASAL INTUBATION BY VIDEO-LARYNGOSCOPE WITH AND WITHOUT BOUGIE IN PATIENTS UNDERGOING MAXILLOFACIAL SURGERY AT TERTIARY CARE HOSPITAL KARACHI

Abstract

BACKGROUND: Nasotracheal intubation is frequently performed during the maxillofacial and head and neck surgeries to offer secure airway access whereas maintaining surgical field visibility. The use of a bougie has been proposed to facilitate tube guidance and improve first-attempt success. Comparing the nasotracheal intubation using a video-laryngoscope with and without a bougie is thus critical to determine the most effective technique for safe and successful airway management.

OBJECTIVE: To compare the outcome of nasal intubation by video-laryngoscope with and without bougie in patients undergoing maxillofacial surgery at Tertiary Care Hospital, Karachi.

METHODOLOGY: In this prospective comparative cohort study over a period of four months . one hundred ninety-four patients were enrolled at department of maxillofacial surgery department, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi. Patients were allocated into two groups. Group A had patients undergoing NTI using a video laryngoscope with a gum elastic bougie and group B had patients undergoing same procedure using video laryngoscopy without a bougie. We assessed the difficult intubation between both groups, using chi square test, where significance was set at p ≤ 0.05.

RESULTS: One hundred ninety-four patients were analyzed and allocated to two groups. Majority of the patients in both groups were male, in VL with bougie 71 (73.2%) and in VL without bougie 67 (69.1%). Median intubation time was 58 (54-62) seconds in VL without bougie group and 62 (55-67) seconds in VL with bougie group. Statistically notable difference was observed between the groups in terms of difficult intubation, as only 4 (4.1%) patients in VL with bougie had difficult intubation and 12 (12.4%) in VL without bougie (p = 0.03).

CONCLUSION: The outcome in terms of difficult intubation of nasal intubation by video-laryngoscope with bougie in patients who underwent maxillofacial surgery was better than those without bougie.