Background. The Bullard laryngoscope (BL) can be useful in management of the difficult airway. When the endotracheal tube (ETT) is advanced over the original BL stylet, the ETT sometimes makes contact with structures around the vocal cords, especially the right arytenoids. A similar problem also occurs with flexible fiberoptic intubation and it has been shown that use of the Parker Flex-Tip^<TM> tube (PT) usually resolves the problem. In this study we tested our hypothesis that use of the PT might improve ETT passage with the BL. Methods. Forty patients scheduled for elective anesthesia were randomly assigned into group ST (Standard tube) and Group PT. The time taken to achieve successful ETT placement after obtaining the best laryngeal view, the number of attempt at intubation and the incidences of successful intubation at first attempt and of re-direction of the BL during intubation were recorded. The unpaired Student's t-test and chi-square test were employed and p<0.05 was considered significant. Results. Use of The PT reduced from 14±6 to 6±2 sec (p<0.01) the time required for successful ETT placement after the best laryngeal view was obtained. It also reduced from 10/19 to 1/19 (p<0.01) the incidence of requirement for re-direction of the BL during intubation. The incidence of successful intubation at the first attempt (18/19 vs. 15/19) was higher in the PT group but the difference was not statistically significant. Conclusions. During intubation with the BL, use of the PT is associated with more rapid success and a lower incidence of re-direction of the BL during endotracheal intubation when compared to a standard ETT.
