Background and Aims: 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. Methods: 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 P < 0.05. Results: Nasopharyngeal bleeding was comparable between the groups absolute risk difference, 10.0%; 95% confidence interval (CI), −11.8% to 30.7%; P = 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 ( P = 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; P < 0.001). Conclusion: 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.
Manohar et al. (Wed,) studied this question.
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