Comparison of Ease of Awake Intubation Using Traditional Fibreoptic Bronchoscope Versus Hybrid Technique with Videolaryngoscopic Assistance in Patients with Difficult Airway

Background and Aims: Difficult airways pose a significant challenge for intubation. While video laryngoscopes and fiberoptic bronchoscopes (FOB) are effective, they have limitations when used alone. A hybrid technique combining both may improve success. Our study’s primary objective was to compare intubation time between a traditional fiberoptic method versus a hybrid videolaryngoscopic technique in patients with difficult airways. Secondary objectives included assessing ease of intubation, number of attempts, and patient comfort. Methods: This prospective, randomized, observational study enrolled 60 patients with a difficult airway. The airway of patients was topicalized, and those having a percentage of glottic opening score 0 with C-MAC videoscope during awake check laryngoscopy were included in the study. Patients were randomized into two groups: Group F was intubated by traditional awake fiberoptic intubation (AFOI). Awake intubation in Group H was performed using a hybrid technique (FOB with C-MAC videolaryngoscopic assistance). Time to intubate, ease of intubation, number of attempts, and patient comfort score were noted. Results: Mean time to intubation was significantly shorter in Group H (35.57 ± 13.984 s) compared to Group F (76.80 ± 26.484 s, P < 0.001). Intubation was “Easy” in 86.7% of Group H patients versus 33.33% in Group F ( P < 0.001). The number of intubation attempts and hemodynamic stability were comparable between groups. However, patient comfort was significantly higher in Group F, with 70% reporting no reaction compared to 23.33% in Group H ( P < 0.001). Conclusion: The hybrid technique of AFOI with videolaryngoscopic assistance significantly reduced time and improved ease of intubation, though with reduced patient comfort.