Fiberoptic Intubation Using Video Assistance in Children Aged 2 to 10 Years Comparing Lateral and Supine Positions During Non-Head-and-Neck Surgery

What this Trial Is About

Fiberoptic intubation is a well-established technique for managing airways in patients who are awake, sedated, or under anesthesia. This method is especially helpful for patients with difficult airways, such as those with limited mouth opening, neck mobility issues, or higher risk of aspiration. The study addresses the challenge of performing intubation in pediatric patients aged 2 to 10 years undergoing non-head-and-neck surgeries, comparing fiberoptic intubation in the lateral versus supine positions, as there is limited research in children on this topic. Participants will be randomly assigned to two groups one group will have fiberoptic intubation performed in the supine position with the head placed neutrally and a roll under the shoulders, while the other group will be positioned laterally with proper head and neck alignment, a flexed dependent leg, and a pillow between the legs. In both groups, an assistant will hold the tongue forward using gauze and forceps while the operator advances the bronchoscope to visualize the laryngeal inlet and pass the endotracheal tube into the trachea. If oxygen saturation falls to 90%, the intubation will pause for ventilation until levels return to 100%. During the study, researchers will measure the time to intubation, success rate at the first attempt, the total number of attempts, complication rates, and oxygen saturation within specified time frames after bronchoscope insertion. Confirmation of successful intubation will be done using chest auscultation and capnography. The trial is randomized without blinding and aims to assess whether fiberoptic intubation in the lateral position is not inferior to the supine position, with participation lasting throughout the surgical procedure and immediate monitoring after intubation.

Fiberoptic Intubation in Lateral Versus Supine Position in Pediatrics Undergoing Non-head-and-neck Surgery