Patient Experience Following Awake Fibreoptic Intubation Compared to Asleep Fibreoptic Intubation
Study Details
Study Description
Brief Summary
The aim of this observational study is to explore and compare patients' experiences of asleep and awake fibreoptic intubation using a semi qualitative patient questionnaire. In particular, investigators will investigate the occurrence of negative experiences, such as distress and discomfort.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
This study aims to investigate whether there are significant differences in aspects of patient experience during AFOI and asleep fibreoptic intubation. The study will be conducted at University Hospitals Coventry and Warwickshire NHS Trust and Oxford University Hospitals Foundation Trust.
Investigators are not aware of any studies to date comparing patient experiences of AFOI with asleep fibreoptic intubation to ascertain the significant differences in side effects. If there is no evidence of any significant difference in negative patient experiences, this might help to encourage anaesthetists to reduce their threshold for AFOI and to use this as first choice for anticipated difficult airway management.
A member of the research team will approach the patient about the study and obtain written informed consent, if the patient is willing and able to participate. The participant will be provided with a specifically designed questionnaire, covering several aspects of patient experience. A mixture of free response answers and numerical rating scales will be used. The member of the research team approaching the patient with the questionnaire will be blinded to the intubation procedure, ensuring consistent application of the questionnaire and minimising bias. This will then be the end of the study for the participant.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Awake fibre-optic intubation Awake fibre-optic intubation |
|
| Asleep fibre-optic intubation Asleep fibre-optic intubation |
Outcome Measures
Primary Outcome Measures
- To assess the incidence and severity of distress experienced by patients during awake and asleep fibreoptic intubation. [6 - 12 months]
Participants will be asked to rate the discomfort during the procedure on a Visual Analogue Score (0-10). There will also be space for patients to write comments explaining their score. These comments will then be used for content analysis, for example to explore different aspects of the procedure that caused distress.
Secondary Outcome Measures
- Secondary endpoints include the differences in occurrence of patient discomfort, pain and difficulty breathing. [6 - 12 months]
This will be assessed through the patient experience questionnaire, with a mixture of direct questions and the request for more detailed information regarding these answers.
Eligibility Criteria
Criteria
Inclusion Criteria:
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All patients aged 18 years and above
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Patients who underwent head and neck or dental surgery and required awake or asleep fibreoptic intubation
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Patients who underwent elective surgery
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Are able and willing to provide written informed consent
Exclusion Criteria:
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Patients who do not consent to be part of the study
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Patients below 18 years old If a translator is not available at the time, participants who cannot reasonably read and communicate in English
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Those who did not undergo awake or asleep fibreoptic intubation
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Those who underwent emergency surgery
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University Hospitals Coventry & Warwickshire NHS Trust | Coventry | West Midlands | United Kingdom | CV2 2DX |
| 2 | Oxford University Hospitals | Oxford | United Kingdom | OX3 7LE |
Sponsors and Collaborators
- University Hospitals Coventry and Warwickshire NHS Trust
- Oxford University Hospitals NHS Trust
Investigators
- Study Chair: Ceri Jones, University Hospitals of Coventry and Warwickshire
- Principal Investigator: Cyprian Mendonca, MD,FRCA, University Hospitals of Coventry and Warwickshire
Study Documents (Full-Text)
None provided.More Information
Publications
- Allan AG. Reluctance of anaesthetists to perform awake intubation. Anaesthesia. 2004 Apr;59(4):413.
- Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011 May;106(5):617-31. doi: 10.1093/bja/aer058. Epub 2011 Mar 29.
- El-Boghdadly K, Onwochei DN, Cuddihy J, Ahmad I. A prospective cohort study of awake fibreoptic intubation practice at a tertiary centre. Anaesthesia. 2017 Jun;72(6):694-703. doi: 10.1111/anae.13844.
- Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, O'Sullivan EP, Woodall NM, Ahmad I; Difficult Airway Society intubation guidelines working group. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015 Dec;115(6):827-48. doi: 10.1093/bja/aev371. Epub 2015 Nov 10.
- Heidegger T, Gerig HJ, Ulrich B, Kreienbühl G. Validation of a simple algorithm for tracheal intubation: daily practice is the key to success in emergencies--an analysis of 13,248 intubations. Anesth Analg. 2001 Feb;92(2):517-22.
- Knudsen K, Nilsson U, Högman M, Pöder U. Awake intubation creates feelings of being in a vulnerable situation but cared for in safe hands: a qualitative study. BMC Anesthesiol. 2016 Aug 30;16(1):71. doi: 10.1186/s12871-016-0240-z.
- Mavridou P, Dimitriou V, Manataki A, Arnaoutoglou E, Papadopoulos G. Patient's anxiety and fear of anesthesia: effect of gender, age, education, and previous experience of anesthesia. A survey of 400 patients. J Anesth. 2013 Feb;27(1):104-8. doi: 10.1007/s00540-012-1460-0. Epub 2012 Aug 3.
- McNarry AF, Dovell T, Dancey FM, Pead ME. Perception of training needs and opportunities in advanced airway skills: a survey of British and Irish trainees. Eur J Anaesthesiol. 2007 Jun;24(6):498-504. Epub 2007 Jan 8.
- Patil V, Barker GL, Harwood RJ, Woodall NM. Training course in local anaesthesia of the airway and fibreoptic intubation using course delegates as subjects. Br J Anaesth. 2002 Oct;89(4):586-93.
- Schnack DT, Kristensen MS, Rasmussen LS. Patients' experience of awake versus anaesthetised orotracheal intubation: a controlled study. Eur J Anaesthesiol. 2011 Jun;28(6):438-42. doi: 10.1097/EJA.0b013e328343222d.
- Wanderer JP, Ehrenfeld JM, Sandberg WS, Epstein RH. The changing scope of difficult airway management. Can J Anaesth. 2013 Oct;60(10):1022-4. doi: 10.1007/s12630-013-9999-2. Epub 2013 Jul 30.
- Wiles MD, McCahon RA, Armstrong JAM. Fibreoptic intubation rates in a UK teaching hospital. Proceedings of the Anaesthetic Research Society Meeting. Br J Anaesth 2010; 105 (5): 729P
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