{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:35:53Z","timestamp":1786739753725,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/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":[[2026,1]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims:<\/jats:title>\n There is a lack of research on the best head position for orotracheal intubation using a flexible fiberoptic bronchoscope (FOB) in cases of nasal pathology and restricted mouth opening, such as in trauma. We conducted a study to compare the effects of neutral and extended head positions for awake fiberoptic orotracheal intubation.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n The study was a prospective, randomized comparative study on 50 patients aged 19\u201370. After obtaining ethical clearance and written informed consent, the patients were randomly divided into two groups, with 25 patients in each group. In Group E, a 7-cm pillow was positioned under the shoulder to keep the occiput close to the operating table. In Group N, no pillow was used during fiberoptic bronchoscopy and intubation. The primary objective entailed the comparison of the percentage of glottic opening score (POGO) between the two groups. The secondary objectives encompassed the measurement of the time required for the insertion of flexible FOB from the incisors to the carina (T1) and the time taken for advancement of the endotracheal tube into the trachea over FOB (T2).<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The POGO score was significantly higher in Group E compared to Group N (\n P<\/jats:italic>\n < 0.0001), while T1 and T2 were significantly lower in Group E (\n P<\/jats:italic>\n < 0.001). The hemodynamic parameters and postoperative complications were comparable between the groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The extended head position improves the POGO score and reduces the insertion time for oral awake fiberoptic intubation.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joacp.joacp_644_24","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T12:00:24Z","timestamp":1762948824000},"page":"18-23","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of POGO score in neutral and extended head positions during awake orotracheal intubation using a flexible bronchoscope in adults with difficult airways"],"prefix":"10.4103","volume":"42","author":[{"given":"Shalu","family":"Yadav","sequence":"first","affiliation":[{"name":"King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Shukla","sequence":"additional","affiliation":[{"name":"King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Hemlata","sequence":"additional","affiliation":[{"name":"King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj Kumar","family":"Chaurasiya","sequence":"additional","affiliation":[{"name":"King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reetu","family":"Verma","sequence":"additional","affiliation":[{"name":"King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Kohli","sequence":"additional","affiliation":[{"name":"King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"R1-20251226","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/j.1365-2044.2006.04780.x","article-title":"A comparison of an anterior jaw lift manoeuvre with the Berman airway for assisting fibreoptic orotracheal intubation","volume":"61","author":"Iqbal","year":"2006","journal-title":"Anaesthesia"},{"key":"R2-20251226","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/bja\/87.2.207","article-title":"Manoeuvres used to clear the airway during fibreoptic intubation","volume":"87","author":"Durga","year":"2001","journal-title":"Br J Anaesth"},{"key":"R3-20251226","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/j.1365-2044.2004.04119.x","article-title":"A comparison of direct laryngoscopy and jaw thrust to aid fibreoptic 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of vocal cord view between neutral and sniffing position during orotracheal intubation using fiberoptic bronchoscope: A prospective, randomized cross over study","volume":"19","author":"Park","year":"2019","journal-title":"BMC Anesthesiol"},{"key":"R10-20251226","doi-asserted-by":"crossref","first-page":"874","DOI":"10.4103\/ija.ija_905_21","article-title":"Evaluation of the use of the channeled King Vision video laryngoscope in improving glottic visualisation in patients with limited glottic view with the Macintosh laryngoscope: A prospective observational study","volume":"65","author":"Choudhary","year":"2021","journal-title":"Indian J Anaesth"},{"key":"R11-20251226","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1186\/s12871-021-01397-4","article-title":"Effects of head positions on awake fiberoptic bronchoscope oral intubation: A randomized controlled trial","volume":"21","author":"Liu","year":"2021","journal-title":"BMC Anesthesiol"},{"key":"R12-20251226","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1111\/anae.13837","article-title":"Accuracy, intra-and inter-rater reliability of three scoring systems for the glottic view at videolaryngoscopy","volume":"72","author":"O'Loughlin","year":"2017","journal-title":"Anaesthesia"},{"key":"R13-20251226","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.4103\/0019-5049.340669","article-title":"Comparison of two external manoeuvres with the conventional technique on glottic visualisation using a C-MAC\u00aevideolaryngoscope in children for elective surgery","volume":"66","author":"Yazhini","year":"2022","journal-title":"Indian J Anaesth"},{"key":"R14-20251226","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1213\/00000539-200301000-00057","article-title":"Advancing the tracheal tube over a flexible fiberoptic bronchoscope by a sleeve mounted on the insertion cord","volume":"96","author":"Ayoub","year":"2003","journal-title":"Anesth Analg"},{"key":"R15-20251226","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000084304","article-title":"Effectiveness of the jaw-thrust maneuver in opening the airway: A flexible fiberoptic endoscopic study","volume":"67","author":"Uzun","year":"2005","journal-title":"ORL"},{"key":"R16-20251226","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/j.1365-2044.2004.04119.x","article-title":"A comparison of direct laryngoscopy and jaw thrust to aid fibreoptic intubation","volume":"60","author":"Stacey","year":"2005","journal-title":"Anaesthesia"},{"key":"R17-20251226","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/j.1365-2044.2006.04780.x","article-title":"A comparison of an anterior jaw lift manoeuvre with the Berman airway for assisting fibreoptic orotracheal 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