Comparison of Ease of Awake Intubation Using Traditional Fibreoptic Bronchoscope Versus Hybrid Technique with Videolaryngoscopic Assistance in Patients with Difficult Airway.
Mahesh Madhu, Sunil Rajan, Fazil Haleel et al.
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In 30 seconds
This prospective randomized study compared traditional awake fibreoptic intubation with a hybrid fibreoptic technique assisted by a C-MAC videolaryngoscope in 60 patients with difficult airways and a glottic opening score of 0 on awake check laryngoscopy. The hybrid approach shortened mean intubation time to 35.57 ± 13.984 s, compared with 76.80 ± 26.484 s for traditional fibreoptic intubation (P < 0.001), and was more often rated easy. Patient comfort was lower with the hybrid technique; attempt numbers and hemodynamic stability were comparable.
Key findings
- Mean intubation time was 35.57 ± 13.984 s with the hybrid technique versus 76.80 ± 26.484 s with traditional fibreoptic intubation (P < 0.001).
- Intubation was rated easy in 86.7% of hybrid-group patients versus 33.33% of traditional-group patients (P < 0.001).
- No reaction was reported by 23.33% of hybrid-group patients versus 70% of traditional-group patients (P < 0.001), indicating lower comfort with the hybrid approach.
- The number of attempts and hemodynamic stability were comparable between groups.
Why it matters
Awake intubation in difficult airways requires balancing procedural efficiency with patient tolerance. In this selected population, videolaryngoscopic assistance was associated with faster, more often easy intubation, but reduced comfort. These contrasting outcomes help frame the trade-offs when considering airway techniques, while the findings apply to the specific patients and methods studied.
What to keep in mind
The study included 60 patients selected for a glottic opening score of 0 on awake check laryngoscopy, limiting how broadly the findings can be applied.