Comparison of intubating conditions and complications of nasotracheal intubation using Macintosh laryngoscope with or without bougie: A randomized controlled trial

Abstract

Background and Aim: The purpose of this study was to compare the efficiency of nasotracheal intubation (NTI) using a Macintosh laryngoscope with bougie to a Macintosh laryngoscope without bougie on-time of intubation, the incidence of postintubation bleeding, hemodynamic stress response, and postoperative complications. Materials and Methods: The present randomized blind research was carried out on 120 patients undergoing elective surgeries under general anesthesia. The study population was separated into two groups, each with 60 patients. NTI was performed with bougie using a Macintosh laryngoscope in Group 1 (n = 60) and without the use of a bougie in Group 2 (n = 60) using a Macintosh laryngoscope. Results: In Group 1, 47 (78.33%) patients were successfully intubated in the first attempt, and 13 (21.67%) patients were successfully intubated in the second attempt, whereas in Group 2, 38 (63.33%) patients were intubated in the first attempt and 22 (36.67%) patients required second attempt, with a statistically significant difference. In Group 1, the mean time required for intubation was 31.10 ± 2.36 s, and in Group 2, it took 43.08 ± 2.17 s, P value was statistically significant. In Group 1, the number of patients with a sore throat was 5 (8.33%), with dental injury was 4 (6.67%), and with nasal mucosa laceration was 3 (5%). In Group 2, the number of patients with sore throat was 6 (10%), with dental injury was 6 (10%), and with nasal mucosa, laceration were 5 (8.33%). The difference was not significant in both the groups. Hemodynamic variables were comparable among the groups. Conclusion: Bougie-guided NTI resulted in more successful intubation in terms of less number of attempts, less time taken for intubation, and less postintubation bleeding as compared to NTI without bougie.