Σάββατο 26 Μαρτίου 2016

A practical approach in difficult intubation: use of gum elastic bougie on 10 cases

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Uğur Altınışık, Mesut Erbaş, Hasan Ali Kiraz, Tuncer Şimşek, Hatice Betül Altınışık, Fatoş İpek Türk, Hüseyin Toman, Hasan Şahin.
Objective: When faced with unexpected difficult intubation, despite all the technological advances, there is still a need of equipments that are easy to use and very reachable. In this study,we offer our experiences in use of gum elastic bougie in 10 cases with unexpected difficult intubation in our operation rooms. Material and Methods: In Çanakkale 18 March University Medical Facultys Operating Rooms and between the years 2013-2014, all the encountered unexpected difficult intubation cases are classified and the patients who has Mallampati score I-II and having any airway pathology evaluated for the use of Gum elastic bougie (GEB). Auxiliary equipments used in intubation, number of intubation attempts, number of anesthesiologists who tried for intubation, the number of trials with GEB and the complications due to the use of GEB were recorded. Results: A total of 10 cases with unexpected difficult intubation were included in the study. All of the cases were male and intubation was attempted with size 4 blades. Stylet in 6 cases, fast trach laryngeal mask in 1 case were used after unsuccessful intubation attempts. However the use of this equipments patients couldnt be intubated and after at least 3 three attempts GEB used this time for intubation. An experienced anesthesiologist with the help of GEB intubated all the patients at once. There were no complications related to the use of GEB. Conclusion: GEB is widely used in European countries for unexpected difficult intubation. In our patients, despite the absence of any complications, due to the blind insertion of bougie trauma cases have been reported. GEB when performed by an experienced anesthesiologist is a good alternative airway equipment in unexpected difficult airway management, because its inexpensive, easy to use and portable.


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