Universal Stylet Bougie in Patients with Cervical Neck Immobilization.

The Universal Stylet Bougie, or USB™, represents a significant advance in the design and development of tracheal introducers (bougies) and stylets. Traditionally, the design requirements of styles and bougies have always been considered incompatible. A stylet requires sufficient rigidity to allow the tracheal tube to be manipulated to a variety of angles, whereas a bougie needs to be flexible enough to allow positive tracheal ring feedback to allow correct placement.

The unique design of the USB™ means the device can be used as a stylet or as a bougie. It consists of two metals inserted on both sides and a flexible middle section. The USB can easily be manipulated to a variety of angles when used as a stylet, yet has the flexibility when used as a bougie. In addition, the hexagonal shape provides less contact with the inner surface of the tracheal tube, providing particularly easy insertion and removal.

In this study we are simulating a difficult intubating condition by limiting the cervical neck extension through applying a rigid neck collar. Subsequently, we will assess whether using the USB device could improve the successful rate of intubation in these patients.

Inclusion criteria

• ASA (American society of Anesthesiologists) physical status 1-2.
• Age 18- 60 years old of both sexes.
• Patients undergoing elective surgery under general anesthesia and tracheal intubation.

Exclusion criteria

• Age < 18 years and ≥ 60 years
• Pregnancy
• Patients with BMI >35 kg m-2
• Emergency surgery or full stomach
• Patients with suspected difficult airway {e.g., high neck circumference, airway masses, mouth scars, neck scars, or history of snoring).
• Patients with cervical spine pathology
• Patients with any cardiac disorders