{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:38:47Z","timestamp":1786649927931,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"\n Background and Aims:<\/jats:title>\n The conventional nasotracheal intubation (NTI) technique is associated with nasal trauma, bleeding, and intubation difficulties. A modified approach using a nasopharyngeal airway as a conduit for bougie-guided NTI has been proposed to reduce nasal trauma. This study aimed to compare the nasopharyngeal airway-guided bougie technique for NTI with conventional NTI in adults.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This prospective randomised controlled study was conducted on 60 American Society of Anesthesiologists' physical status (ASA-PS) classification I and II adult patients undergoing elective surgeries. Patients were assigned to two groups: Group C (conventional NTI) and Group B (bougie-guided NTI using a nasopharyngeal airway). Primary outcomes included comparing the severity of nasopharyngeal bleeding. Secondary outcomes included ease of insertion, intubation time, first-pass success rate, and need for additional manoeuvres. Statistical analysis was performed using appropriate tests with a significance threshold of\n P<\/jats:italic>\n < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Nasopharyngeal bleeding was comparable between the groups [absolute risk difference, 10.0%; 95% confidence interval (CI), \u221211.8% to 30.7%;\n P<\/jats:italic>\n = 0.371]. The first-pass success rate was higher in Group B than in Group C (96.7% vs 93.3%), although the difference was not statistically significant (\n P<\/jats:italic>\n = 1.000). The intubation time was significantly shorter in Group C than in Group B (64.03 s vs 116.00 s; mean difference, 51.97 s; 95% CI, 37.55 to 66.39;\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Bougie-guided NTI using a nasopharyngeal airway did not significantly reduce nasopharyngeal bleeding compared with the conventional technique. While success rates were similar, the longer intubation time may limit its routine use when rapid airway control is required.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_1638_25","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T15:00:08Z","timestamp":1776524408000},"page":"562-569","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Conventional versus nasopharyngeal airway-guided bougie technique for nasotracheal intubation in adult patients: A randomised controlled study"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9781-2544","authenticated-orcid":false,"given":"Manisha","family":"Manohar","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Pt. B.D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8993-9924","authenticated-orcid":false,"given":"Suresh Kumar","family":"Singhal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pt. B.D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9371-1319","authenticated-orcid":false,"given":"Bonam Sathish","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Pt. B.D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"R1-20260418","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/j.1365-2044.1996.tb07746.x","article-title":"Pathological changes associated with short-term nasal intubation","volume":"51","author":"O\u2019connel","year":"1996","journal-title":"Anaesthesia"},{"key":"R2-20260418","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/BF03022218","article-title":"Nasotracheal intubation under curve tipped suction catheter guidance reduces epistaxis","volume":"53","author":"Morimoto","year":"2006","journal-title":"Can J Anaesth"},{"key":"R3-20260418","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1111\/anae.14029","article-title":"Nasotracheal intubation over a bougie vs. non-bougie intubation: A prospective randomised, controlled trial in older children and adults using videolaryngoscopy","volume":"72","author":"Abrons","year":"2017","journal-title":"Anaesthesia"},{"key":"R4-20260418","doi-asserted-by":"crossref","first-page":"57","DOI":"10.4103\/ams.ams_190_19","article-title":"Evaluation of nasopharyngeal airway to facilitate nasotracheal intubation","volume":"10","author":"Dhakate","year":"2020","journal-title":"Ann Maxillofac Surg"},{"key":"R5-20260418","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/(SICI)1097-0258(19960115)15:1<1::AID-SIM134>3.0.CO;2-E","article-title":"Formulae and tables for the determination of sample size and power in clinical trials for testing differences in proportions for the two-sample design: A review","volume":"15","author":"Sahai","year":"1996","journal-title":"Stat Med"},{"key":"R6-20260418","doi-asserted-by":"crossref","first-page":"757","DOI":"10.4103\/ija.ija_466_22","article-title":"A study to evaluate nasotracheal intubation using Airtraq laryngoscope with a bougie and without a bougie","volume":"66","author":"Bansal","year":"2022","journal-title":"Indian J Anaesth"},{"key":"R7-20260418","first-page":"96","article-title":"Effect of bougie-guided nasal intubations upon bleeding: A randomised controlled trial","volume":"46","author":"Vadhanan","year":"2017","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R8-20260418","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1213\/ANE.0000000000002853","article-title":"Comparison of nasal intubations by GlideScope with and without a Bougie guide in patients who underwent maxillofacial surgeries: Randomized clinical trial","volume":"126","author":"Pourfakhr","year":"2018","journal-title":"Anaesth Analg"},{"key":"R9-20260418","doi-asserted-by":"crossref","first-page":"89.e1","DOI":"10.1016\/j.joms.2020.08.029","article-title":"Does a nasal airway facilitate Nasotracheal intubation or not? A prospective, randomized, and controlled study","volume":"79","author":"Canpolat","year":"2021","journal-title":"J Oral Maxillofac Surg"},{"key":"R10-20260418","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/00000542-200201000-00014","article-title":"Nasotracheal intubation: A randomized trial of two methods","volume":"96","author":"Elwood","year":"2002","journal-title":"Anaesthesiology"},{"key":"R11-20260418","doi-asserted-by":"crossref","first-page":"26","DOI":"10.2344\/0003-3006-58.1.26","article-title":"Reducing nasopharyngeal trauma: The urethral catheter-assisted nasotracheal intubation technique","volume":"58","author":"Wong","year":"2011","journal-title":"Anaesth Prog"},{"key":"R12-20260418","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1093\/bja\/aeq205","article-title":"Xylometazoline pretreatment reduces nasotracheal intubation-related epistaxis in paediatric dental surgery","volume":"105","author":"El-Seify","year":"2010","journal-title":"Br J Anaesth"},{"key":"R13-20260418","first-page":"193","article-title":"Softened endotracheal tube reduces the incidence and severity of epistaxis following nasotracheal intubation","volume":"36","author":"Lu","year":"1998","journal-title":"Acta Anaesthesiol Si"},{"key":"R14-20260418","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1213\/00000539-200009000-00038","article-title":"Thermosoftening treatment of the nasotracheal tube before intubation can reduce epistaxis and nasal damage","volume":"91","author":"Kim","year":"2000","journal-title":"Anesth Analg"},{"key":"R15-20260418","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1213\/ANE.0000000000003822","article-title":"Is tube thermosoftening helpful for videolaryngoscope-guided nasotracheal intubation? 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