Dr. Nilambaree S. Adke, Dr. Jayashree Dakhane


Introduction: The incidence of difficult intubation ranges from 1% to 4%, In these circumstances the gum elastic bougie is often successful.

Aim: To compare ease of tracheal intubation using the gum elastic bougie versus malleable stylet.

Material and methods: A total of 100 adult patients undergoing elective surgery tracheal intubation was indicated were selected and divided randomly into, Gum elastic bougie group and Malleable stylet group equally.

Results: The study groups were comparable on characteristics like age, sex, weight distribution, ASA grading, laryngoscopic view of larynx. In both the groups BURP improves laryngoscopic visualization of larynx highly significantly.  The mean time taken for successful tracheal intubation in ‘restricted’ grade was significantly less in Gum elastic bougie group (30.92+0.49 sec) than Malleable stylet group (37.16 + 1.99 sec).

Conclusion: Gum elastic bougie is good option for successful endotracheal intubation in the difficult airway.


Difficult intubation, endotracheal, Gum elastic bougie

Full Text:



. Raúl Carrillo-Esper, Brenda Vinay-Ramírez, Alejandro Bahena. The BURP maneuver. Images in Anesthesiology. January-March 2008; Vol. 31. No. 1: 63-65.

J. P. NOLAN AND M. E. WILSON. An evaluation of the gum elastic bougie Intubation times and incidence of sore throat. Anaesthesia. 1992; Volume 47: 878-881.

S. Rao Mallampati et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can anaesth soc j. 1985; 32: 4: 429-34.

Patil V U, stehlinl GC , zaudeh RL. Predicting the difficulty of intubation using an intubation gauge. Anesthesiology Review. 1983; X: 32-3.

D. SAVVA. Prediction of difficult tracheal intubation. British Journal of Anaesthesia. 1994; 73: 149-153

Bennister FB, Macbeth RG. Direct laryngoscopy and tracheal intubation. The Lancet. 1944; Volume 244, Issue 6325: 651-654.

Tse JC, Rimm EB, Hussain A. Predicting Difficult Endotracheal Intubation in Surgical Patients Scheduled for General Anesthesia: A Prospective Blind Study. Anesthesia & Analgesia. AUG 1995; 81(2):254-258.

Wilson ME, Spiegelhalter D., Robertson JA, Lesser P. Predicting difficult intubation. Br. J. Anaesth. 1988; 61: 211-216.

Cook TM. A new practical classification of laryngeal view. Anaesthesia. 2000; 55: 260–287.

Latto IP, Stacey M, Mecklenburgh J, Vaughan RS. Survey of the use of the gum elastic bougie in clinical practice. Anaesthesia, 2002; 57: 379 – 384.

Noguchi T., Koga K., Shiga Y., Shigematsu A.The gum elastic bougie eases tracheal intubation while applying cricoid pressure compared to a stylet. CAN J ANESTH. 2003; 50: 7: 712–717.

Benumof JL. Management of the difficult adult airway, With special emphasis on awake tracheal intubation. Anaesthesiology. 1991 Dec;75(6):1087-110.

Richard L. Knill MD, Anaesthetic Techniques Difficult laryngoscopy made easy with a "BURP". CAN J ANAESTH. 1993; 40:3: 279-82.

Benumof JL, Cooper SD. Quantitative improvement in laryngoscopic view by optimal external laryngeal manipulation. J Clin Anesth. 1996 Mar; 8(2):136-40.

Takahata O., Kubota M., Mamiya K., Akama Y., Nozaka T., Matsumoto H., et al. The Efficacy of the "BURP" Maneuver During a Difficult Laryngoscopy. Anesthesia & Analgesia. FEB 1997; 84(2): 419-421.

Randell T., Maattanen M., Kytta J. The best view at laryngoscopy using the McCoy laryngoscope with and without cricoid pressure. Anaesthesia. 1998; 53: 536–539

Gataure PS., Vaughan RS., Latto IP., Simulated difficult intubation Comparison of the gum elastic bougie and the stylet. Anaesthesia. 1996; Volume 51: 935-938.

Christensen AM., Larsen HW., Lundby L., Jakobsen KB. Postoperative throat complaints after tracheal intubation. British Journal of Anaesthesia. 1994; 73: 786-787.


  • There are currently no refbacks.