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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT05736198
Other study ID # 2023-0181
Secondary ID
Status Not yet recruiting
Phase
First received
Last updated
Start date June 12, 2023
Est. completion date March 1, 2034

Study information

Verified date May 2023
Source University of Illinois at Chicago
Contact Alexandra Barabanova, MS
Phone (312)355-5733
Email barabano@uic.edu
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

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.


Description:

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.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 96
Est. completion date March 1, 2034
Est. primary completion date June 15, 2033
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility 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. Exclusion Criteria: - Anyone who does not meet the inclusion criteria

Study Design


Related Conditions & MeSH terms


Intervention

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

Locations

Country Name City State
United States University of Illinois Chicago Illinois

Sponsors (1)

Lead Sponsor Collaborator
University of Illinois at Chicago

Country where clinical trial is conducted

United States, 

References & Publications (1)

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. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Desaturation Measurement using pulse oximetry (percent saturation) During intubation
Primary Hemodynamic Lability mm Hg During intubation
Primary Dose of Fentanyl Used mcg During intubation
Secondary Patient overall experience assessed by VAS satisfaction. Polling will be taken to measure patients' satisfaction with each sedation regiment on the scale from 1-10 24 hours after the surgery
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