Using Ultrasound for Bougie Insertion in Difficult Airway Management

Ultrasound-Guided Bougie Insertion Technique and Conventional Method in Difficult Intubation: A Randomized Controlled Study

Difficult airway management remains one of the biggest challenges in anesthesia practice. The Gum elastic bougie, an intubation tool, is frequently used to facilitate intubation in difficult situations. Recently, ultrasound-guided airway management has been used as a potential method to improve the intubation process. This study aims to compare the efficacy of ultrasound-guided bougie insertion with the conventional method regarding the duration of endotracheal tube (ETT) insertion and the number of attempts required in a difficult intubation population.

The goal of this clinical trial is to learn if using ultrasound during bougie insertion in difficult airway patients will improve the success rate and reduce the time of insertion. The main questions it aims to answer are:

Does using ultrasound reduce the number of insertion attempts? Does using ultrasound reduce the duration of bougie insertion?

Researchers will compare the ultrasound-guided technique to the conventional bougie insertion method. They will also assess both groups' hemodynamic parameters during and after the procedure and the success rate from the first trial.

Inclusion Criteria:

• Adults aged 15 -75 years.
• Elective surgical operation.
• ASA (American Society of Anesthesiologists) physical status I-III.
• Predicted difficult airway.

Exclusion Criteria:

• Emergency intubations.
• Patients with contraindications to the use of bougie.
• Patients with a known allergy to local anesthetics or ultrasound gel.
• Pregnancy.
• Craniofacial anomaly
• Patients with obstructive sleep apnea
• BMI > 35.
• Patient with gastroesophageal reflux disease.