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Updated: Mar 2, 2026

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
Less postoperative sore throat after nasotracheal intubation using a fiberoptic bronchoscope than using a Macintosh
Nobuko Tachibana1, Yukitoshi Niiyama1, Michiaki Yamakage1
1Department of Anesthesiology, Sapporo Medical University School of Medicine, South 1 West 16 Chuo-ku, Sapporo, Hokkaido 060-8556, Japan.
Study Objective:
To evaluate whether nasotracheal intubation using a fiberoptic bronchoscope reduces postoperative sore throat.
Design:
Prospective, double-blinded, randomized, and controlled study.
Setting:
Postoperative areas and surgical ward of a university hospital.
Patients:
Seventy-four patients with American Society of Anesthesiologists physical status I-II who were scheduled for elective general anesthesia requiring nasotracheal intubation.
Interventions:
Patients were randomized to one of two intubation groups, F (fiberoptic bronchoscope-guided) and M (Macintosh laryngoscope-guided), and after induction of general anesthesia, the patients' tracheas were intubated via the nose.
Measurements:
The intensity of postoperative sore throat was evaluated using a numerical rating score (0=none, 10=severe) at 24 hours postoperatively, and the incidence of nasal mucosal trauma, time to completion of intubation, and hemodynamic responses were recorded and compared between groups.
Main Results:
The numerical rating score value was significantly lower in group F than in group M (P=.0047), but the incidence of nasal mucosal trauma was comparable between the two groups. The median time to completion of intubation was shorter for group F than group M (P<.0001). Hemodynamic responses were not significantly different.
Conclusions:
Fiberoptic bronchoscope-guided intubation is associated with less sore throat after nasotracheal intubation than M intubation. The time to completion of intubation was significantly shorter using the fiberoptic bronchoscope than that using the Macintosh laryngoscope.
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