A comparison of Disposcope endoscope and Fiberoptic bronchoscope during awake orotracheal intubation in obese patients with anticipated difficult airway: a prospective, randomized and controlled clinical trial

Fiberoptic bronchoscope (FOB) has been the preferred instrument for many years in the management of difficult airway. Disposcope endoscope (DE) is a new medical device for tracheal intubation. This study intended to compare the feasibility and safety issues of FOB and DE during awake orotracheal intubation. Forty obese patients with anticipated difficult airway undergoing awake orotracheal intubation were included in this study. All the patients were randomly allocated to awake orotracheal intubation using FOB (FOB group) or DE (DE group) after conscious sedation. The time was required to view the vocal cords and to complete the intubation, the conditions of intubation, the hemodynamic changes during intubation and the adverse events after surgery were recorded. The visual analog scale (VAS) scores of the easy experiences for viewing the vocal cords and passing the tracheal tube through the glottis evaluated by the operator were also recorded. The time of viewing the vocal cords was shorter in the DE group (32.3 +/- 13.3 s) than that in the FOB group (46.5 +/- 22.3 s) (P = 0.03). The time of successful tracheal intubation was shorter in the DE group (37.0 +/- 14.0 s) when compared with that in the FOB group (66.3 +/- 28.4 s) (P < 0.01). The coughing scores were higher in the DE group (2.9 +/- 1.1) than that in the FOB group (2.7 +/- 0.9) (P = 0.04). The limb movement scores were higher in the DE group (3.9 +/- 0.3) when compared with that in the FOB group (3.4 +/- 1.1) (P = 0.04). The tolerance scores during intubation were higher in the DE group (3.6 +/- 0.6) than that in the FOB group (3.0 +/- 0.9) (P = 0.04). The VAS scores of the easy experiences for viewing the vocal cords and passing the tracheal tube through the glottis were higher in the DE group than that in the FOB group (P < 0.05); The incidence of throat pain after surgery was lower in the DE group when compared with that in the FOB group (P < 0.05). The results showed that Disposcope endoscope provided shorter intubation time, better intubation conditions and lower incidence of throat pain compared with Fiberoptic bronchoscope during awake orotracheal intubation in obese patients with anticipated difficult airway.