The airway management is a vital act in anesthesia. The gold standard technique for planned very difficult intubation is nasotracheal fiberoptic intubation. The success rate with this procedure is 98.8%. However, learning this technique is difficult and it's considered uncomfortable by patients and practitioners. The Airtraq® videolaryngoscope is commonly used for difficult orotracheal intubation. Cases of awake intubation by Airtraq® have been described. Furthermore, the French Society of Anesthesia-Resuscitation, in its last formalized expert recommendations (2017) on difficult intubation, proposes the use of video laryngoscopes as an alternative to the fiberoptic bronchoscope. We propose a non-inferiority study evaluating the use of Airtraq® for the realization of a awake intubation compared to the gold standard (fiberoptic bronchoscope). This prospective randomized study should include 78 patients in two groups. The purpose of this study is to improve the comfort of patient and practitioner during an awake tracheal intubation, to facilitate the learning of the technique.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
78
Awake orotracheal intubation with laryngeal nerve block and remifentanil sedation
Awake nasotracheal intubation with laryngeal nerve block and remifentanil sedation
CHU de Caen
Caen, Normandy, France
Success of orotracheal or nasotracheal intubation.
Defined by the visualization of the tube into the trachea through vocal cords and by the appearance of the capnogram
Time frame: 1 day
Length of the proceedings
Duration between the insertion of device and the appearance of capnogram
Time frame: 1 day
Rate of occurrence of adverse events
Coughing, desaturation, agitation
Time frame: 1 day
Patient satisfaction score
Analogue visual scale graduated from zero to ten. Zero is the worst imaginable satisfaction and 10 is the better imaginable satisfaction.
Time frame: 1 day
Operator satisfaction score
Analogue visual scale graduated from zero to ten. Zero is the worst imaginable satisfaction and 10 is the better imaginable satisfaction.
Time frame: 1 day
Number of intubation attempts
Time frame: 1 day
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