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

NCT ID: NCT01070537

Last Updated: 2010-02-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-02-29

Study Completion Date

2009-04-30

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.

Detailed Description

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Conditions

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Carcinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Interventions

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Bonfils fiberscope intubation

Intervention Type DEVICE

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
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Leon Berard

OTHER

Sponsor Role lead

Responsible Party

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Centre Léon Bérard - 28 rue Laennec - 69373 LYON Cedex 08 - France

Principal Investigators

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Jean-Edgard Mazères, MD

Role: PRINCIPAL_INVESTIGATOR

Centre Leon Berard

Locations

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Centre Léon Bérard

Lyon, , France

Site Status

Countries

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France

References

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Benumof JL. Management of the difficult adult airway. With special emphasis on awake tracheal intubation. Anesthesiology. 1991 Dec;75(6):1087-110. doi: 10.1097/00000542-199112000-00021.

Reference Type BACKGROUND
PMID: 1824555 (View on PubMed)

Arne J, Descoins P, Fusciardi J, Ingrand P, Ferrier B, Boudigues D, Aries J. Preoperative assessment for difficult intubation in general and ENT surgery: predictive value of a clinical multivariate risk index. Br J Anaesth. 1998 Feb;80(2):140-6. doi: 10.1093/bja/80.2.140.

Reference Type BACKGROUND
PMID: 9602574 (View on PubMed)

Boisson-Bertrand D, Bourgain JL, Camboulives J, Crinquette V, Cros AM, Dubreuil M, Eurin B, Haberer JP, Pottecher T, Thorin D, Ravussin P, Riou B. [Difficult intubation. French Society of Anesthesia and Intensive Care. A collective expertise]. Ann Fr Anesth Reanim. 1996;15(2):207-14. No abstract available. French.

Reference Type BACKGROUND
PMID: 8734245 (View on PubMed)

Halligan M, Charters P. A clinical evaluation of the Bonfils Intubation Fibrescope. Anaesthesia. 2003 Nov;58(11):1087-91. doi: 10.1046/j.1365-2044.2003.03407.x.

Reference Type BACKGROUND
PMID: 14616594 (View on PubMed)

Bein B, Worthmann F, Scholz J, Brinkmann F, Tonner PH, Steinfath M, Dorges V. A comparison of the intubating laryngeal mask airway and the Bonfils intubation fibrescope in patients with predicted difficult airways. Anaesthesia. 2004 Jul;59(7):668-74. doi: 10.1111/j.1365-2044.2004.03778.x.

Reference Type BACKGROUND
PMID: 15200542 (View on PubMed)

Bein B, Yan M, Tonner PH, Scholz J, Steinfath M, Dorges V. Tracheal intubation using the Bonfils intubation fibrescope after failed direct laryngoscopy. Anaesthesia. 2004 Dec;59(12):1207-9. doi: 10.1111/j.1365-2044.2004.03967.x.

Reference Type BACKGROUND
PMID: 15549980 (View on PubMed)

Fahey MR, Morris RB, Miller RD, Sohn YJ, Cronnelly R, Gencarelli P. Clinical pharmacology of ORG NC45 (NorcuronTM): a new nondepolarizing muscle relaxant. Anesthesiology. 1981 Jul;55(1):6-11. doi: 10.1097/00000542-198107000-00003.

Reference Type BACKGROUND
PMID: 6113794 (View on PubMed)

Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984 Nov;39(11):1105-11.

Reference Type BACKGROUND
PMID: 6507827 (View on PubMed)

Fleming TR. One-sample multiple testing procedure for phase II clinical trials. Biometrics. 1982 Mar;38(1):143-51.

Reference Type BACKGROUND
PMID: 7082756 (View on PubMed)

Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J. 1974 Jun 22;2(5920):656-9. doi: 10.1136/bmj.2.5920.656.

Reference Type BACKGROUND
PMID: 4835444 (View on PubMed)

Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, Liu PL. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J. 1985 Jul;32(4):429-34. doi: 10.1007/BF03011357.

Reference Type BACKGROUND
PMID: 4027773 (View on PubMed)

Loh KS, Irish JC. Traumatic complications of intubation and other airway management procedures. Anesthesiol Clin North Am. 2002 Dec;20(4):953-69. doi: 10.1016/s0889-8537(02)00022-6.

Reference Type BACKGROUND
PMID: 12512271 (View on PubMed)

Mazeres JE, Lefranc A, Cropet C, Steghens A, Bachmann P, Perol O, Rosay H. Evaluation of the Bonfils intubating fibrescope for predicted difficult intubation in awake patients with ear, nose and throat cancer. Eur J Anaesthesiol. 2011 Sep;28(9):646-50. doi: 10.1097/EJA.0b013e3283495b85.

Reference Type DERIVED
PMID: 21743336 (View on PubMed)

Other Identifiers

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ET2007-036

Identifier Type: REGISTRY

Identifier Source: secondary_id

INVIBO

Identifier Type: -

Identifier Source: org_study_id

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