PMID- 37957962
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231117
IS  - 2227-9032 (Print)
IS  - 2227-9032 (Electronic)
IS  - 2227-9032 (Linking)
VI  - 11
IP  - 21
DP  - 2023 Oct 24
TI  - Awake Nasal Fiberoptic Intubation in Lateral Position for Severely Obese Patients 
      with Anticipated Difficult Airway: A Randomized Controlled Trial.
LID - 10.3390/healthcare11212818 [doi]
LID - 2818
AB  - BACKGROUND: Obesity is a well-recognized risk factor for difficult intubation. To 
      safely manage and overcome airway challenges in severely obese patients with a 
      suspected difficult airway, awake fiberoptic intubation is recommended. We aimed 
      to investigate the utility of awake nasal fiberoptic intubation in severely obese 
      patients with suspected difficult airway while positioning them in the lateral 
      decubitus position. METHODS: This randomized controlled trial compared lateral 
      and supine positions for awake nasal fiberoptic intubation in severely obese 
      patients with an anticipated difficult airway by assessing the success rate, time 
      needed to secure the airway, peri-procedural adverse events, and postoperative 
      satisfaction of patients. RESULTS: Sixty patients with a median age of 37 
      [inter-quartile range (IQR): 29-44] years were included, of which 47 (78.3%) were 
      females. The median body mass index (BMI) was 45.5 [IQR: 42.5-50.8] kg/m(2). The 
      success rate of fiberoptic intubation was 100% in both groups. The time needed to 
      successfully secure the airway was 188 [148.8-228.8] seconds (s) in the lateral 
      position, compared to 214.5 [181.8-280.5] s in supine position (p = 0.019). 
      Intraprocedural cough was more common in the supine position group (n = 8; 
      26.7%), compared to the lateral position group (n = 3; 10%; p = 0.095). 
      Postoperative sore throat was more common in the lateral position group (n = 12; 
      40%) compared to the supine position (n = 5; 16.7%; p = 0.045). CONCLUSIONS: In 
      conclusion, Intubation in the lateral position is a promising technique that is 
      equivalent to the routine supine position during fiberoptic intubation. In fact, 
      intubation in the lateral position took less time to successfully secure the 
      airway.
FAU - Ababneh, Omar
AU  - Ababneh O
AUID- ORCID: 0000-0001-5447-4648
AD  - Department of Anesthesia and Intensive Care, School of Medicine, The University 
      of Jordan, Amman 11942, Jordan.
FAU - Bsisu, Isam
AU  - Bsisu I
AUID- ORCID: 0000-0002-8999-8334
AD  - Department of Anesthesia and Intensive Care, School of Medicine, The University 
      of Jordan, Amman 11942, Jordan.
AD  - UCSF Center for Health Equity in Surgery and Anesthesia, San Francisco, CA 94158, 
      USA.
FAU - El-Share', Ahmad I
AU  - El-Share' AI
AUID- ORCID: 0000-0003-0878-4666
AD  - Department of Anesthesia and Pain Management, King Hussein Cancer Center, Amman 
      11941, Jordan.
FAU - Alrabayah, Mustafa
AU  - Alrabayah M
AUID- ORCID: 0000-0001-6390-4080
AD  - Department of Anesthesia and Intensive Care, School of Medicine, The University 
      of Jordan, Amman 11942, Jordan.
FAU - Qudaisat, Ibraheem
AU  - Qudaisat I
AD  - Department of Anesthesia and Intensive Care, School of Medicine, The University 
      of Jordan, Amman 11942, Jordan.
FAU - Alghanem, Subhi
AU  - Alghanem S
AD  - Department of Anesthesia and Intensive Care, School of Medicine, The University 
      of Jordan, Amman 11942, Jordan.
FAU - Khreesha, Lubna
AU  - Khreesha L
AUID- ORCID: 0000-0001-6465-8424
AD  - Department of Special Surgeries, School of Medicine, The University of Jordan, 
      Amman 11942, Jordan.
FAU - Ali, Amani Mohamed
AU  - Ali AM
AD  - Department of Undergraduate Studies, School of Medicine, The University of 
      Jordan, Amman 11942, Jordan.
FAU - Rashdan, Mohammad
AU  - Rashdan M
AUID- ORCID: 0000-0003-4518-1573
AD  - Department of General Surgery, School of Medicine, The University of Jordan, 
      Amman 11942, Jordan.
LA  - eng
PT  - Journal Article
DEP - 20231024
PL  - Switzerland
TA  - Healthcare (Basel)
JT  - Healthcare (Basel, Switzerland)
JID - 101666525
PMC - PMC10649994
OTO - NOTNLM
OT  - anesthesiology
OT  - instrumentation
OT  - intubation
OT  - obesity
COIS- The authors declare no conflict of interest.
EDAT- 2023/11/14 06:43
MHDA- 2023/11/14 06:44
PMCR- 2023/10/24
CRDT- 2023/11/14 02:05
PHST- 2023/10/02 00:00 [received]
PHST- 2023/10/20 00:00 [revised]
PHST- 2023/10/21 00:00 [accepted]
PHST- 2023/11/14 06:44 [medline]
PHST- 2023/11/14 06:43 [pubmed]
PHST- 2023/11/14 02:05 [entrez]
PHST- 2023/10/24 00:00 [pmc-release]
AID - healthcare11212818 [pii]
AID - healthcare-11-02818 [pii]
AID - 10.3390/healthcare11212818 [doi]
PST - epublish
SO  - Healthcare (Basel). 2023 Oct 24;11(21):2818. doi: 10.3390/healthcare11212818.