Endotracheal Tube Threading Over the Fiberoptic Bronchoscope
Condition: Fiberoptic Guided Intubation
Study type: Interventional

Summary: 
      The goal of this study is to assess the ease of ETT threading over the FOB on the right or
      left labial commissures in patients aging between 18 and 70 years old with ASA score I-II and
      undergoing any type of surgery. The main question it aims to answer is whether threading the
      tube on the right labial commissure during FOB intubation has a better success rate than
      threading the tube on the left labial commissure. Participants will be randomized via a
      computerized system into 2 groups (Group 1: Patients intubated with FOB by threading the tube
      on the left labial commissure and Group 2: Patients intubated with FOB by threading the tube
      on the right labial commissure). Researchers will compare the success rate of threading the
      tube on first trial, number of ETT threading trials, time to success, and incidence of
      intra-procedural complication between the two groups to see if threading the tube on the
      right labial commissure during FOB intubation has a better success rate than threading the
      tube on the left labial commissure.
    

Detailed description: 
      Fiberoptic bronchoscope (FOB) intubation is the gold standard technique for intubating
      patients with predicted difficult airway. Different maneuvers have been used to facilitate
      threading the endotracheal tube (ETT) over the fiberoptic bronchoscope including jaw thrust,
      stretching the tongue, rotating the ETT 90 degrees anticlockwise or using smaller tubes. To
      our knowledge threading the ETT with the FOB on the left or right lip commissures has not
      been investigated previously. Improving the ease of ETT threading on the right or left labial
      commissures could change our FOB intubation management.

      The aim is to assess the ease of ETT threading over the FOB on the right or left labial
      commissures.

      Patients between 18 and 70 years old with ASA score I-II and undergoing any type of surgery
      in the operating rooms at the American University of Beirut Medical Center will be randomized
      via a computerized system into 2 groups:

      Group 1: Patients intubated with FOB by threading the tube on the left labial commissure
      Group 2: Patients intubated with FOB by threading the tube on the right labial commissure The
      primary outcome is the success rate of threading the tube on first trial. Secondary outcomes
      include number of ETT threading trials, time to success, and incidence of intra-procedural
      complications.
    

Intervention name(s): Threading on the left lip commissure; Threading on the right lip commmissure
Intervention type(s): Procedure; Procedure
Intervention description(s): Threading of the endotracheal tube over the fiberoptic bronchscope from the left lip commissure; Threading of the endotracheal tube over the fiberoptic bronchoscope from the right lip commissure
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Endotracheal intubation; Fiberoptic bronchoscope