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Atomization Vs. Nebulization for Airway Topicalization During Awake Nasotracheal Fiberoptic Intubation

NCT05320731 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 150

Last updated 2024-08-30

No results posted yet for this study

Summary

Intubation of difficult airway is a challenge for anesthetist. There many causes of difficult airway, and previous studies concluded that awake fiber-optic intubation (AFOI) is the gold standard for the management of these patients. Several studies showed that airway nerve blocks provide rapid and deep airway anesthesia, however, due to their several disadvantages, topicalization of the airway represents a promising alternative to them. Some studies revealed that nebulization and atomization of the airway provide adequate anesthesia for AFOI. In the present study, we try to find out which is more effective for topicalization of the airway during nasotracheal AFOI; nebulization or atomization. We used a simple atomization device as a modification of the McKenzie technique.

Conditions

  • Awake Fiberoptic Intubation

Interventions

PROCEDURE

Nebulization with lidocaine

A face mask nebulizer with oxygen flow rate of 8 L/min will be used to deliver 10 mL of 2% lidocaine. Patients will be encouraged to inhale deeply to facilitate entrainment of nebulized LA into their airway. Adequate topical anesthesia will be confirmed by heaviness or numbness of the tongue.

PROCEDURE

Atomization with lidocaine

A simple atomization device as a modification of the McKenzie technique will be used. One end of oxygen bubble tubing will be cut to fit into the barrel of 1 mL syringe and attached to one connector of a 3-way tap. A 10-mL syringe filled with 2% lidocaine will be attached to the other connector of the 3-way tap. A 6 Fr suction catheter, with its colored end cut and its distal blind end cut open, will be attached to oxygen bubble tubing via the male Luer connector of the 3-way tap. The other end of bubble tubing will be then attached to an oxygen source turned on to deliver a flow of 6 L/min. As LA is slowly atomized as a jet-like spray, the catheter will be directed towards the soft palate and posterior pharynx in a controlled fashion during patients' inspiration to topicalize the airway. Patients will be asked to take full vital capacity breaths of atomized LA contained oxygen. Adequate topical anesthesia will be confirmed by tongue heaviness or numbness

Sponsors & Collaborators

  • Zagazig University

    lead OTHER_GOV

Principal Investigators

  • Ashraf A Torki, MD · Anesthesia and surgical intensive care, zagazig university, faculty of medicine

  • Mona A Shahin, MD · Anesthesia and surgical intensive care, zagazig university, faculty of medicine

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Model
PARALLEL

Eligibility

Min Age
18 Years
Max Age
60 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2022-02-20
Primary Completion
2024-07-20
Completion
2024-08-15

Countries

  • Egypt

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT05320731 on ClinicalTrials.gov