Videolaryngoscope Versus Fiberoptic Bronchoscope for the Awake Intubation

Study Overview
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Brief Summary
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Endotracheal intubation of the morbidly obese is often performed awake. Fiberoptic bronchoscope assisted endotracheal intubation, a commonly utilized technique for securing an airway while a patient is awake, has many limitations. The video laryngoscope is a device that is similar to a conventional laryngoscope but uses a video system to visualize the larynx. Because of its low cost, ease of use, and usefulness in the presence of edema or bleeding that may obstruct the airway, video assisted laryngoscopy has been shown to be useful for awake endotracheal intubations. However, a direct comparison of the fiberoptic bronchoscope with video assisted laryngoscopy has not been performed for awake endotracheal intubations in of obese patients. Patients undergoing laparoscopic gastric bypas andrecquiring awake intubations will be randomized for either fiberoptic bronchoscope or video assisted laryngoscopy. The investigators primary outcome will be the time required for successful intubation.

Conditions
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Need of Awake Intubation for Difficult Airways

Intervention / Treatment
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* Device: Videolaryngoscope
* Device: Fiberoptic


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: morbidly obese patient presenting for bariatric surgery at the Royal Victoria Hospital Exclusion Criteria: moderate to severe systemic illness, i.e. American Society of Anesthesiologists (ASA) score of 4 or higher inability to communicate in English or French contraindications to the drugs used in the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Videolaryngoscope<br>Intubation by videolaryngoscope | Device: Videolaryngoscope<br> <br> * Other names: Intubation by Glidoscope;|
| Active Comparator: Fiberoptic<br>Intubation by fibroscope | Device: Fiberoptic<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The time required for successful intubation | The time required for successful intubation, which will be measured as the time from which the bronchoscope or videolaryngoscope is initially introduced into the oropharynx, until the time that CO2 is registered on the capnogram. | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of intubation attempts, defined as a complete withdrawal and re-insertion of the airway instrument. |  | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Awake intubation, Videolaryngoscope, Fiberoptic