Evaluation of the Bonfils Fiberscope for Predicted Difficult Intubation in Awake Patients With Ear, Nose, and Throat (ENT) Cancer (INVIBO)

Study Overview
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Brief Summary
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The Bonfils intubation fiberscope (BF), a rigid medical device with a curved tip, is exclusively used in anesthesiology for orotracheal intubation (OTI). The objective of the study was to evaluate the feasibility and the tolerance of an intubation procedure realized by means of the BF (BFI) in awake adult patients with predicted difficult intubation (PDI), in the context of ENT cancer surgery. The intubation is performed under local anesthesia (either nasal, oral, or intercricothyroidal) and sedation using Remifentanyl (AIVOC) with spontaneous ventilation. The primary endpoint is the rate of BFI meeting quality requirements: the procedure must be both successful (≤ 2 attempts and duration < 180 sec) and well tolerated (Fahey score < 2). The secondary endpoints include the difficulties met by the operator during the BFI and patient's perception of the intubation procedure, evaluated in the recovery room and 7 days after the intervention. Sample size is calculated using a one-stage Fleming design with p0=80%, p1=95%, alpha=5% and 80% power, for a total of 32 evaluable patients.

Official Title
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INVIBO: Evaluation of the Feasibility and Tolerance of an Intubation Procedure Performed by Means of the Bonfils Fiberscope in Awake Patients With Predicted Difficult Intubation in the Context of ENT Cancer Surgery

Conditions
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Carcinoma

Intervention / Treatment
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* Device: Bonfils fiberscope intubation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male or female patients aged ≥ 18 years Requiring a surgical intervention for an ENT carcinoma Presenting with a PDI defined either as an Arne Score > 11, or a previous history of DI or by the surgeon's judgment. Able to understand, read and write French Signed, written informed consent Exclusion Criteria: Impossible mask ventilation Patient with a laryngeal stridor indicative of upper airway stenosis Patient requiring an intubation by nasal route Glasgow score < 12 BMI > 35 Pregnant or lactating women Documented history of cognitive or psychiatric disorders Difficult follow-up

Ages Eligible for Study
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Minimum Age: 18 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

Intervention Model: Single Group Assignment


Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Bonfils fiberscope intubation|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The rate of BFI meeting quality requirements: the procedure must be successful on the one hand (≤ 2 attempts and duration < 180 sec); and well tolerated on the other hand (Fahey score < 2). |  | 180 sec after the beginning of the intubation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of well-tolerated BFI procedures |  | At the end of the intubation | 
| Duration of the intubation procedure among patients with a successful BFI (≤ 2 attempts and duration < 180 sec) |  | At the end of the intubation | 
| Frequency and type of difficulties met by the operator |  | At the end of the intubation | 
| Frequency and type of adverse events experienced by the patient |  | At the end of the intubation | 
| Patient's perception of the intubation procedure |  | In the recovery room and 7 days after the intubation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Otolaryngology, Equipment and Supplies, Intubation