Combined Use of Glidescope With Fiber Optic Broncscopy Versus Fiber Optic Alone in Difficult Intubation

NCT05751590 | Completed

• 1 other identifier: FMASU R08/2023
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

In spite of the development of a lot of airway devices in the past 2 decades, tracheal intubation problems were the most common primary airway problems. The GlideScope® Video Laryngoscope (Verathon, Bothell, WA) is a video laryngoscopy system with a two-segment blade, the distal portion of which houses a charge-coupled device that contains a micro-video camera that transmits images to a 7-inch video liquid crystal display (LCD) monitor. The GlideScope® can be used for routine intubation but is also commonly used as an alternative device for difficult or failed airways. It is particularly useful in cases where cervical motion or mouth opening is limited, preventing creation of a "straight line" of sight from the operator to the glottis . GlideScope improves the laryngeal view as one of its advantages due to the blade angle of 60° which is designed to improve the glottic view without the need of alignment of the oral, pharyngeal, and tracheal axes and also without adding additional lifting force. Fibreoptic intubation with a flexible bronchoscope is an important airway management skill in which anaesthesiologists should be proficient. Unfortunately, clinical experience shows that even with reasonable experience and practice, fibreoptic intubation can be challenging. It requires a high degree of manual dexterity, an ability to manoeuvre quickly under stressful clinical situations, and rigorous training and practice to maintain a high level of skill. Thus, whereas fibreoptic intubatThus, whereas fibreoptic intubation can be used rapidly for intubation, video laryngoscopy may be an effective alternative, especially in patients with an anticipated difficult airway. However, it remains unclear whether video-assisted airway management using the GlideScope provides significant advantages over flexible bronchoscopy in patients with potentially difficult airways , Video laryngoscopy is increasingly used for difficult airway management in anaesthesia, intensive care units and emergency departments. Recently, video laryngoscopy has been incorporated into various difficult airway management algorithms, being recommended as one of the initial steps in the management of difficult airways .

Conditions

Anesthesia

Outcome Measures

Primary Outcomes (1)

• Endotracheal intubation

  Intubation time is defined as the time from insertion of either the GlideScope combined with the Fiberoptic broncscopy or the Fiberoptic broncscopy alone into the mouth, to the time when end tidal CO2 exceeded (20 mmHg)

  1st seconds till succesfull intubation

Study Arms (2)

Glidescope + Fiberoptic broncscopy

ACTIVE COMPARATOR

Device: comined use of gliddescope and fiberoptic broncscopy

Fiberoptic broncscopy

ACTIVE COMPARATOR

Device: fiberoptic bronscopy

Interventions

comined use of gliddescope and fiberoptic broncscopy DEVICE

endotrachotreal intubation will be done by combined use of Glidescope and Fiberoptic broncscopy

Glidescope + Fiberoptic broncscopy

fiberoptic bronscopy DEVICE

endotrachotreal intubation will be done by Fiberoptic broncscopy

Fiberoptic broncscopy

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• patients who will be scheduled for elective surgery requiring orotracheal or nasotracheal intubation with anticipated difficult intubation.
• physical status American Society of Anesthesiologists (ASA) I - III.

You may not qualify if:

• Patients who refuse to participate
• patients with body mass index (BMI) \>35 kg/m2
• coagulopathy, severe thrombocytopenia \<50×103.
• Pregnant females
• physical status American Society of Anesthesiologists (ASA)\>IV
• patients requiring rapid sequence induction
• patients with closed mouth opening who are candidates only for nasal intubation

Sponsors & Collaborators

• Ain Shams University: lead

Study Sites (1)

Ain Shams University hospitals

Cairo, Egypt

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor

Study Record Dates

• First Submitted: February 21, 2023
• First Posted: March 2, 2023
• Study Start: March 10, 2023
• Primary Completion: June 15, 2024
• Study Completion: June 15, 2024
• Last Updated: July 30, 2024

Record last verified: 2024-07

Locations

EG (1)