{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:48:02Z","timestamp":1768877282998,"version":"3.49.0"},"reference-count":17,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003345","name":"CAMS","doi-asserted-by":"crossref","award":["I2M-5\u2013011"],"award-info":[{"award-number":["I2M-5\u2013011"]}],"id":[{"id":"10.13039\/501100003345","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Key R&D Program of China","award":["2018YFC2001800"],"award-info":[{"award-number":["2018YFC2001800"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Awake tracheal intubation (ATI) involves placing a tracheal tube in an awake, spontaneously breathing patient. Superior laryngeal nerve block (SLNB) can effectively abolish the glottic closure reflex, and blunt the sensation of the structures above the cords. A method that consists of SLNB along with translaryngeal injection (TLI) can provide satisfactory anaesthesia and intubating conditions. We present a novel modified access of SLNB, ultrasound (US)-guided anterior SLNB, to aid awake videolaryngoscopes-assisted endotracheal intubation in adult elective surgery patients, and we compare the effectiveness and safety to traditional US-guided posterior SLNB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>A total of 100 adult elective surgery patients requiring general endotracheal anaesthesia will be randomly assigned to the modified group (modified US-guided anterior SLNB) or the traditional group (traditional US-guided posterior SLNB). After SLNB, all participants will be performed with TLI. The primary outcome is the proportion of acceptable intubation conditions based on intubation scores. Secondary outcomes include: (a) the first-attempt intubation success rate, (b) haemodynamic changes during ATI, (c) time taken for airway anaesthesia and intubation, (d) recall of intubation, (e) participant perception of comfort during intubation, (f) perioperative complication rate. This report describes the study design of this randomised controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>The study protocol has been approved by an ethical committee of the West China Hospital (Sichuan University), and registered at the Chinese Clinical Trials Register (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"www.chictr.org.cn\">www.chictr.org.cn<\/jats:ext-link>). Results will be published in a peer-reviewed journal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>ChiCTR2200058086.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068779","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T16:06:32Z","timestamp":1677600392000},"page":"e068779","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of modified anterior and traditional posterior accesses for ultrasound-guided superior laryngeal nerve block in awake endotracheal intubation: study protocol for a randomised non-inferiority clinical trial"],"prefix":"10.1136","volume":"13","author":[{"given":"Yusi","family":"Hua","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiyuan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9125-3916","authenticated-orcid":false,"given":"Guo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4557-8872","authenticated-orcid":false,"given":"Tao","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"2023022808051651000_13.2.e068779.1","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/anae.14904","article-title":"Difficult airway Society guidelines for awake tracheal intubation (ATI) in adults","volume":"75","author":"Ahmad","year":"2020","journal-title":"Anaesthesia"},{"key":"2023022808051651000_13.2.e068779.2","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1007\/BF03016686","article-title":"Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation","volume":"48","author":"Takita","year":"2001","journal-title":"Can J Anaesth"},{"key":"2023022808051651000_13.2.e068779.3","doi-asserted-by":"crossref","first-page":"3613","DOI":"10.31557\/APJCP.2020.21.12.3613","article-title":"Airway blocks vs la nebulization- an interventional trial for awake fiberoptic bronchoscope assisted nasotracheal intubation in oral malignancies","volume":"21","author":"Chavan","year":"2020","journal-title":"Asian Pac J Cancer Prev"},{"key":"2023022808051651000_13.2.e068779.4","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/00008506-199504000-00004","article-title":"A comparison of anesthetic techniques for awake intubation in neurosurgical patients","volume":"7","author":"Reasoner","year":"1995","journal-title":"J Neurosurg Anesthesiol"},{"key":"2023022808051651000_13.2.e068779.5","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes203"},{"key":"2023022808051651000_13.2.e068779.6","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.jclinane.2015.07.016","article-title":"The thyrohyoid membrane as a target for ultrasonography-guided block of the internal branch of the superior laryngeal nerve","volume":"27","author":"Stopar-Pintaric","year":"2015","journal-title":"J Clin Anesth"},{"key":"2023022808051651000_13.2.e068779.7","doi-asserted-by":"crossref","unstructured":"Chan A-W , Tetzlaff JM , G\u00f8tzsche PC , et al . 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