Asleep Fiberoptic vs Direct Laryngoscopy Effect on Hemodynamic Stability Using Opioid Free Anesthesia Induction

NCT ID: NCT06487988

Last Updated: 2025-12-19

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

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-11

Study Completion Date

2026-01-01

Brief Summary

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The goal of this clinical trial is to compare blood pressure and heart rate between the fiberoptic and direct oral intubation using opioid free anesthesia induction. Secondary objectives include comparing the time needed for intubation and the incidence of postoperative sore throat, hoarseness, and upper airway trauma in adults aging between 18 to 55 years, scheduled for elective surgery under general anesthesia.

The main question it aims to answer is:

Does fiberoptic intubation cause less hemodynamic instability than direct oral intubation using opioid free anesthesia induction?

Detailed Description

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Background: Intubation has always been linked to a transient increase in blood pressure and heart rate that could be deleterious in elderly and hemodynamically unstable patients. Fiberoptic intubation, which is currently used for suspected difficult intubation, could cause less marked rise in blood pressure and heart rate. Furthermore, "opioid free anesthesia" has gained popularity lately to avoid opioid adverse effects ranging from respiratory depression, postoperative ileus, sedation, nausea, vomiting and urinary retention.

Specific aims: The primary objective of this study is to compare blood pressure and heart rate between the fiberoptic and direct oral intubation using opioid free anesthesia induction. Secondary objectives include comparing the time needed for intubation and the incidence of postoperative sore throat, hoarseness, and upper airway trauma.

Methods: In this prospective randomized clinical trial, 90 (45 in each group) adults aging between 18 to 55 years, scheduled for elective surgery under general anesthesia, will be recruited over 1 year of work. Patients will be randomly allocated to 2 groups: The direct conventional laryngoscopy group performed with N3 (for females) or N4 (for males) Macintosh laryngoscope blade, and the fiberoptic guided intubation group.

Significance: Studies comparing hemodynamic stability using fiberoptic intubation versus direct oral intubation in opioid free anesthesia are limited. The present study will assess whether fiberoptic intubation causes less hemodynamic instability than direct oral intubation in opioid free anesthesia induction, which will benefit patients with normal airways.

Conditions

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Analgesics, Opioid Anesthesia, General Heart Rate Blood Pressure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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The direct conventional laryngoscopy group

The direct conventional laryngoscopy group will be performed with N3 (for females) or N4 (for males) Macintosh laryngoscope blade.

Group Type ACTIVE_COMPARATOR

direct conventional laryngoscopy

Intervention Type DEVICE

direct conventional laryngoscopy will be performed with N3 (for females) or N4 (for males) Macintosh laryngoscope blade.

The fiberoptic guided intubation group

The fiberoptic guided intubation will be performed.

Group Type EXPERIMENTAL

fiberoptic guided intubation

Intervention Type DEVICE

fiberoptic guided intubation will be performed.

Interventions

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direct conventional laryngoscopy

direct conventional laryngoscopy will be performed with N3 (for females) or N4 (for males) Macintosh laryngoscope blade.

Intervention Type DEVICE

fiberoptic guided intubation

fiberoptic guided intubation will be performed.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* ASA (American Society of Anesthesiologists) physical status I and II
* Range age of 18-55 years' old
* Scheduled for elective surgery under general anesthesia.

Exclusion Criteria

* History of cardiovascular diseases.
* History of lung disease.
* Hypertensive patient (BP\> 140/90)
* Patient taking medications that affect blood pressure and heart rate
* Morbid obesity (BMI \>30)
* Severe GERD
* Predicted difficult airway (Short TMD \<6 cm, Upper li bite test grade III, Mallampati score

\>III)
* Neck instability
* Patient planned to receive rapid sequence intubation
* Patient refusal to participate
* History of difficult intubation/ ventilation
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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American University of Beirut Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Christian Rouphael

Clinical Instructor of Anesthesia

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christian Rouphael, MD

Role: PRINCIPAL_INVESTIGATOR

American University of Beirut Medical Center

Locations

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Christian Rouphael

Beirut, , Lebanon

Site Status RECRUITING

Countries

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Lebanon

Central Contacts

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Christian Rouphael, MD

Role: CONTACT

Phone: 01 350 000

Email: [email protected]

Thuraya HajAli, MSc

Role: CONTACT

Phone: 01 350 000

Email: [email protected]

Facility Contacts

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Christian Rouphael, M.D.

Role: primary

Other Identifiers

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BIO-2023-0271

Identifier Type: -

Identifier Source: org_study_id