{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:49:49Z","timestamp":1789487389992,"version":"build-2803163510"},"reference-count":24,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Xiamen Health Science and Technology Development Program for High-Quality Development","award":["2024GZL-QN081"],"award-info":[{"award-number":["2024GZL-QN081"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,25]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>As the established gold standard for difficult airway management, flexible bronchoscope-guided endotracheal intubation nonetheless carries certain technical constraints. This study is designed to conduct a comparative analysis of multiple indicators including nasotracheal intubation duration between the modified flexible lightwand (MFL) and the conventional flexible bronchoscope (FB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This prospective, single-centre, single-blind, parallel-group, randomised controlled trial will be conducted at a tertiary grade A university-affiliated hospital in China. The study plans to enrol 70 oromaxillofacial surgery patients requiring nasotracheal intubation under general anaesthesia. Participants will be randomly allocated to either the MFL group (n=35) or the FB group (n=35).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study has been approved by the Ethics Committee of the First Affiliated Hospital of Xiamen University (2025(210)). Written informed consent will be obtained from all participants. The research findings will be disseminated through publication in peer-reviewed journals and presentations at relevant academic conferences or forums.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2500112183<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115008","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:01:01Z","timestamp":1789480861000},"page":"e115008","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the modified flexible lightwand versus flexible bronchoscope for nasotracheal intubation: a protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4136-5884","authenticated-orcid":false,"given":"Yingchuan","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaijian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuncui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingxiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3498-8853","authenticated-orcid":false,"given":"Ruolan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-5565","authenticated-orcid":false,"given":"Bin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"2026091507004661000_16.9.e115008.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2003.03034.x"},{"key":"2026091507004661000_16.9.e115008.2","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-023-39768-1","article-title":"Comparison of nasotracheal versus orotracheal intubation for sedation, assisted spontaneous breathing, mobilization, and outcome in critically ill patients: an exploratory retrospective analysis","volume":"13","author":"Grensemann","year":"2023","journal-title":"Sci Rep"},{"key":"2026091507004661000_16.9.e115008.3","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jclinane.2016.10.026","article-title":"Less postoperative sore throat after nasotracheal intubation using a fiberoptic bronchoscope than using a Macintosh laryngoscope: A double-blind, randomized, controlled study","volume":"39","author":"Tachibana","year":"2017","journal-title":"J Clin Anesth"},{"key":"2026091507004661000_16.9.e115008.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12871-022-01910-3","article-title":"Impact of choice of nostril on nasotracheal intubation when using video rigid stylet: a randomized clinical trial","volume":"22","author":"Wang","year":"2022","journal-title":"BMC Anesthesiol"},{"key":"2026091507004661000_16.9.e115008.5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/anae.13232","article-title":"Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway\u00ae","volume":"71","author":"Lee","year":"2016","journal-title":"Anaesthesia"},{"key":"2026091507004661000_16.9.e115008.6","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1111\/anae.13124","article-title":"Awake nasotracheal intubation using videolaryngoscopy or fibreoptic bronchoscopy","volume":"70","author":"Xue","year":"2015","journal-title":"Anaesthesia"},{"key":"2026091507004661000_16.9.e115008.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-008-0645-9"},{"key":"2026091507004661000_16.9.e115008.8","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31827773b2"},{"key":"2026091507004661000_16.9.e115008.9","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/j.1365-2044.2011.06659.x","article-title":"GlideScope\u00ae vs flexible fibreoptic scope for elective intubation in obese patients","volume":"66","author":"Abdelmalak","year":"2011","journal-title":"Anaesthesia"},{"key":"2026091507004661000_16.9.e115008.10","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200505000-00008"},{"key":"2026091507004661000_16.9.e115008.11","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1097\/EJA.0b013e32832b13a2","article-title":"Blind intubation device for nasotracheal intubation in 100 oral and maxillofacial surgery patients with anticipated difficult airways: a prospective evaluation","volume":"26","author":"Sun","year":"2009","journal-title":"Eur J Anaesthesiol"},{"key":"2026091507004661000_16.9.e115008.12","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/S0196-0644(05)82177-8","article-title":"Nasotracheal intubation using a flexible lighted stylet","volume":"19","author":"Verdile","year":"1990","journal-title":"Ann Emerg Med"},{"key":"2026091507004661000_16.9.e115008.13","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.jclinane.2008.08.020","article-title":"A modified lightwand-guided nasotracheal intubation technique for oromaxillofacial surgical patients","volume":"21","author":"Cheng","year":"2009","journal-title":"J Clin Anesth"},{"key":"2026091507004661000_16.9.e115008.14","doi-asserted-by":"publisher","DOI":"10.1007\/BF03021066"},{"key":"2026091507004661000_16.9.e115008.15","doi-asserted-by":"crossref","DOI":"10.1097\/00000542-199902000-00049","article-title":"Use of a modified lightwand for nasal intubation","volume":"90","author":"Iseki","year":"1999","journal-title":"Anesthesiology"},{"key":"2026091507004661000_16.9.e115008.16","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-025-05419-2","article-title":"Peri-intubation complications in critically ill obese patients: a secondary analysis of the international INTUBE cohort","volume":"29","author":"Russotto","year":"2025","journal-title":"Crit Care"},{"key":"2026091507004661000_16.9.e115008.17","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1097\/EJA.0000000000001462","article-title":"For nasotracheal intubation, which nostril results in less epistaxis: right or left?: A systematic review and meta-analysis","volume":"38","author":"Tan","year":"2021","journal-title":"Eur J Anaesthesiol"},{"key":"2026091507004661000_16.9.e115008.18","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1111\/anae.12176","article-title":"The effect of the jaw-thrust manoeuvre on the ability to advance a tracheal tube over a bronchoscope during oral fibreoptic intubation","volume":"68","author":"Han","year":"2013","journal-title":"Anaesthesia"},{"key":"2026091507004661000_16.9.e115008.19","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199808000-00031"},{"key":"2026091507004661000_16.9.e115008.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2009.10.003"},{"key":"2026091507004661000_16.9.e115008.21","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/EJA.0b013e328332845a","article-title":"Cardiovascular responses and airway complications following awake nasal intubation with blind intubation device and fibreoptic bronchoscope: a randomized controlled study","volume":"27","author":"Sun","year":"2010","journal-title":"Eur J Anaesthesiol"},{"key":"2026091507004661000_16.9.e115008.22","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/PEC.0b013e3181aba8c1","article-title":"Fibreoptic and videoscopic indirect intubation techniques for intubation in children","volume":"25","author":"Levin","year":"2009","journal-title":"Pediatr Emerg Care"},{"key":"2026091507004661000_16.9.e115008.23","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aef226"},{"key":"2026091507004661000_16.9.e115008.24","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1007\/s12630-023-02687-w","article-title":"A comparative evaluation of fibreoptic bronchoscopy versus C-MAC\u00ae D-BLADE-guided videolaryngoscopy for nasotracheal intubation under general anesthesia in oropharyngeal carcinoma surgery patients","volume":"71","author":"Kumar","year":"2024","journal-title":"Can J Anaesth"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-115008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:01:04Z","timestamp":1789480864000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-115008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":24,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,15]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bmjopen-2025-115008"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-115008","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}