Nasotracheal Intubation Over a Bougie

Conventional nasotracheal intubation techniques (or "Conventional Videolaryngoscopic Techniques," CVT) are known to be associated with significant trauma to the patient's nares and the endotracheal tube itself. The investigators propose an alternative technique (Nasotracheal intubation over a bougie placed via a subsequently removed nasal trumpet, or NIB) which involves using Seldinger technique over a bougie placed via a nasal trumpet which promises to not only be less traumatic to the patient and the endotracheal tube, but also to take less time to perform and have a higher first-attempt success rate than conventional methods. The investigators propose a randomized prospective interventional study comparing this new technique with conventional technique to see if a significant difference exists.

• Nasotracheal intubation over a bougie (Procedure), also known as Abrons technique for nasotracheal intubation, Nasotracheal intubation over a bougie placed via a subsequently removed nasal trumpet, NIB: Nasotracheal intubation over a bougie, placed with videolaryngoscopy assistance, via a nasopharyngeal airway with or without the aid of Magill forceps
• Conventional Nasotracheal Intubation (Procedure), also known as CVT: Blind passage of an endotracheal tube via the nare followed by videolaryngoscopy-assisted passage through the glottis, with or without the aid of Magill forceps

Primary outcomes

• Nasal trauma [60-90 seconds post-intubation]: Bleeding noted on nasopharyngeal exam by surgical resident

Secondary outcomes

• Nasal trauma [5 minutes post-intubation]: Bleeding noted on nasopharyngeal exam by surgical resident
• Time to intubation [Measured immediately post-intubation]: Time from first entrance of ETT or bougie into the nare to the presence of end-tidal CO2 via nasotracheal ETT
• First attempt success rate [Measured immediately post-intubation]: Whether or not there was successful nasotracheal intubation on the first attempt
• Need for Magill forceps [Measured Immediately post-intubation]: Whether or not Magill forceps were used during airway management

Sex: All, ages: 8 Years to 99 Years, accepts healthy volunteers

Inclusion Criteria:

* Patients scheduled for elective surgery with an anesthetic plan including asleep nasotracheal intubation

Exclusion Criteria:

* Patients needing emergent airway protection
* Patients undergoing emergency surgery
* Patients whom are known to be pregnant
* Patients whom are currently anticoagulated (including daily aspirin use)
* Patients whose anesthetic includes the use of nitrous oxide
* Patients whom are currently incarcerated
* Patients 7 years of age or younger
* Mentally incompetent adults
* Patients whom refuse involvement in the study

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