Comparison of Two Sedation Regimens for Awake Fiberoptic Intubation

NCT ID: NCT05736198

Last Updated: 2024-11-29

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

RECRUITING

Total Enrollment

96 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-08-12

Study Completion Date

2034-03-01

Brief Summary

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The purpose of this study is to examine the effects of different sedation drugs used for the awake fiberoptic intubation procedure. Benzodiazapines and narcotics (such as midazolam and fentanyl) are standard drugs used for sedation during awake fiberoptic intubation. Dexmedetomidine, midazolam, and fentanyl are approved by the Food and Drug Administration (FDA) procedural sedation. These drugs might be given to the patient regardless of their participation in the study.

In addition to midazolam and fentanyl study subjects will also receive either dexmedetomidine or a placebo (a salt solution that contains no drug). It is believed that dexmedetomidine will not slow down breathing as much as the combination of the valium-like drug and narcotic. In our study, we are trying to determine if this is the best drug for sedation during an awake fiberoptic procedure.

Detailed Description

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This is an observational study designed to evaluate effectiveness of two standard of care protocols used for patients with potentially difficult airway during awake fiberoptic intubation.

After obtaining informed consent, patients will be randomized into one of two groups. The first group will receive placebo, midazolam, and fentanyl (titrated to effect) to facilitate the intubation. The second group will receive dexmedetomidine, midazolam, and fentanyl (titrated to effect) to facilitate intubation. Both groups will have a transtracheal injection and/or direct topical application of lidocaine to decrease irritation of the trachea and vocal cords.

As the patients in the study all have potentially difficult airways, the usual precautions will be taken to minimize the risks to the patients. These include the availability of alternative airway devices (including LMAs and Intubating LMA systems). Doses of dexmedetomidine will conform to the recommended dosing schedules of between 0.3 and 0.7 mcg/kg/hour.

All the drug stated above are currently FDA approved and are used according to the standard of care.

Patient medical records will be reviewed to determine the amount of fentanyl that was used to facilitate intubation as well as homodynamic stability during the procedure and oxygen saturation. A brief 5-minute survey will be conducted 24 hours after the surgery to access patient satisfaction with intubation procedure. Intubation conditions stated below will be recorded by the anesthesiologist during the procedure.

The intubating conditions (gagging, discomfort of patient, and oxygen saturation) and hemodynamic stability during the procedure will be recorded by the research assistant and the patient's satisfaction with the undertaking (after the surgery is completed) will be determined as well. The amount of fentanyl used to facilitate intubation will also be recorded.

Conditions

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Awake Fiberoptic Intubation Difficult Airway

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Dexmedetomidine

Dexmedetomidine, midazolam, and fentanyl (titrated to effect) to facilitate intubation

Dexmedetomidine

Intervention Type DRUG

dexmedetomidine, midazolam, and fentanyl (titrated to effect) to facilitate intubation

Placebo

Normal Saline, midazolam, and fentanyl (titrated to effect) to facilitate the intubation

No interventions assigned to this group

Interventions

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Dexmedetomidine

dexmedetomidine, midazolam, and fentanyl (titrated to effect) to facilitate intubation

Intervention Type DRUG

Other Intervention Names

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Precedex

Eligibility Criteria

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Inclusion Criteria

* Subjects with potentially difficult airways who require awake fiberoptic intubations will be identified from the OR schedule and the pre-operative clinic workups.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Illinois at Chicago

OTHER

Sponsor Role lead

Responsible Party

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David Glick

Department of Anesthesiology Head

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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David Glick, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Anesthesiology Head

Locations

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University of Illinois

Chicago, Illinois, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Alexandra Barabanova, MS

Role: CONTACT

(312)355-5733

Facility Contacts

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Alexandra Barabanova, MS

Role: primary

312-355-5733

References

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Scher CS, Gitlin MC. Dexmedetomidine and low-dose ketamine provide adequate sedation for awake fibreoptic intubation. Can J Anaesth. 2003 Jun-Jul;50(6):607-10. doi: 10.1007/BF03018650.

Reference Type BACKGROUND
PMID: 12826556 (View on PubMed)

Other Identifiers

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2023-0181

Identifier Type: -

Identifier Source: org_study_id