Awake Nasal Fiber-optic Intubation of Severely Obese Patients in Lateral Position

University of Jordan

Status: Completed

Conditions: Intubation;Difficult; Anesthesia Intubation Complication; Intubation; Difficult or Failed; Anesthesia

Treatments: Procedure: Fiberoptic intubation in supine position.; Procedure: Fiberoptic intubation in lateral position.

Study type: Interventional

Funder types: Other

Identifiers

NCT04779528

442/2021/67

Details and patient eligibility

About

Airway management in severely obese patients remains a challenging issue for anesthetists and may lead to life-threatening situations. Awake Fiber-Optic Bronchoscopy Intubation (FOBI) technique is considered as the gold standard when a difficult airway is anticipated to secure the airway and to facilitate the surgery. FOBI is usually done in supine position, while (in conscious patients) lateral position is the most recommended position to keep the upper airway patent. This prospective clinical trial study will test whether awake FOBI in Lateral position will provide a safe profile or a significant advantage over FOBI in supine position, in morbidly obese patients undergoing elective bariatric surgery.

Full description

Airway management in severely obese patients remains a challenging issue for anesthetists and may lead to life-threatening situations. Awake Fiber-Optic Bronchoscopy Intubation (FOBI) technique is considered as the gold standard when a difficult airway is anticipated to secure the airway and to facilitate the surgery. FOBI is usually done in supine position, while (in conscious patients) lateral position is the most recommended position to keep the upper airway patent.

This prospective clinical trial study will test whether awake FOBI in Lateral position will provide a safe profile or a significant advantage over FOBI in supine position, in morbidly obese patients undergoing elective bariatric surgery. The main outcome is success rate and duration of the procedure. Secondary outcomes are oxygenation maintenance, hemodynamic stability, airway complication, sedation score, and postoperative airway morbidity in 6 hours after surgery.

Enrollment: 60 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists physical status classification two and three.
• Patients scheduled for elective bariatric surgeries under general anesthesia.

Exclusion criteria

• Refusal of fiberoptic intubation.
• Allergy to local anesthetics.
• Coagulopathy.
• Raised intracranial or intraocular pressure.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

Group S

Experimental group

Description:

Patients will undergo fiberoptic intubation in supine position.

Treatment:

Procedure: Fiberoptic intubation in supine position.

Group L

Experimental group

Description:

Patients will undergo fiberoptic intubation in lateral position.

Treatment:

Procedure: Fiberoptic intubation in lateral position.