To evaluate the ease of endotracheal intubation using preloaded bougie vs standard bougie vs stylet guided technique in difficult airway patients undergoing elective surgeries. A randomised three arm clinical trial.

Successful intubation in the first attempt has been associated with lower incidence of complications. As the number of attempts and the time to intubate increase, injury to airway and risk of desaturation may increase which is potentially life threatening. Various adjuncts and techniques have been devised to facilitate ease of insertion of endotracheal tube during such situations. Tracheal tube introducer, also known as bougie, has been used extensively in difficult airway scenarios to ensure first pass success. Another technique is the use of stylet along with endotracheal tube for intubation. However, it has been noted from previous studies that the usage of bougie leads to less airway trauma as less force needs to be applied during airway manipulation. Preloaded bougie is a modification of the standard technique by which the time taken to introduce endotracheal tube can be minimised. Up to now, only stylet and standard bougie techniques were routinely being used for difficult airway intubation. In this study, we will be using preloaded bougie technique for ease of endotracheal intubation compared with standard bougie and stylet guided techniques in difficult airway.