Simulated difficult intubation. Comparison of the gum elastic bougie and the stylet

Anaesthesia. 1996 Oct;51(10):935-8. doi: 10.1111/j.1365-2044.1996.tb14961.x.


A randomised study was carried out to compare the efficacy of the gum elastic bougie and the stylet in a simulated difficult intubation. A laryngoscopic assessment, as described by Cormack and Lehane, was made in 100 patients. A Grade 3 view was then simulated. In the Bougie First Group (50 patients) two attempts were made to pass a gum elastic bougie and a tracheal tube into the trachea. If these first two attempts were not successful, two further attempts at intubation were allowed with a stylet placed in the tracheal tube. In the Stylet First Group (50 patients) the order was reversed. After two attempts the tube was correctly placed in the trachea in 96% of cases in the Bougie First Group compared to only 66% of cases in the Stylet First Group (p < 0.001). We recommend that a gum elastic bougie should be readily available and that anaesthetists should use it in preference to a stylet whenever a good view of the glottis is not immediately available.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, General*
  • Esophagus
  • Female
  • Foreign Bodies / etiology
  • Humans
  • Intubation, Intratracheal / adverse effects
  • Intubation, Intratracheal / instrumentation*
  • Laryngoscopy
  • Male
  • Middle Aged
  • Time Factors