Comparison of SEEKflex/videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation: a randomized clinical trial
Abstract Background Fibreoptic bronchoscope (FOB) is considered complex to learn and operate, and it remains controversial whether videolaryngoscopy can be used as an alternative to FOB for awake tracheal intubation (ATI). Aims The Objective is to compare the effectiveness of Safe Easy Endotracheal...
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BMC
2025-07-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-03229-1 |
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| author | Wenyun Xu Chenglong Zhu Qinghua Wu Bin Zhao Miao Zhou Yang Liu Yongchu Hu Jianhua Xia Hongbin Yuan Yaohua Yu Zui Zou |
| author_facet | Wenyun Xu Chenglong Zhu Qinghua Wu Bin Zhao Miao Zhou Yang Liu Yongchu Hu Jianhua Xia Hongbin Yuan Yaohua Yu Zui Zou |
| author_sort | Wenyun Xu |
| collection | DOAJ |
| description | Abstract Background Fibreoptic bronchoscope (FOB) is considered complex to learn and operate, and it remains controversial whether videolaryngoscopy can be used as an alternative to FOB for awake tracheal intubation (ATI). Aims The Objective is to compare the effectiveness of Safe Easy Endotracheal kit-flexible (SEEKflex)/video laryngoscopy and FOB in ATI. Methods We conducted a pragmatic, multicentre, non-blinded, randomized, parallel-group clinical trial in Shanghai and Putian, China. Between January 2023 and June 2024, patients aged 18–80 years who required ATI and were able to adapt to videolaryngoscopy were enrolled. We randomly assigned 148 patients who received ATI to two groups in a 1:1 ratio: SEEKflex/videolaryngoscopy group and FOB group. The rate of successful intubation at the first attempt was the primary outcome. Secondary endpoints were time to tracheal intubation; patient-reported satisfaction with the technique; and complications arising from intubation. Results Successful intubation at the first attempt was achieved in 69 cases (93%) using SEEKflex /videolaryngoscopy and only 58 cases (80%) using FOB, p = 0.015. The median (IQR [range]) time to tracheal intubation was 59 (51–66 [29–150]) s in the SEEKflex/videolaryngoscopy group and 92 (77–157 [40–869]) s in the FOB group, p < 0.001. The median (IQR [range]) scores for patient satisfaction were 8 (7–9 [4–10]) and 6 (4–7 [1–10]) in the SEEKflex/videolaryngoscopy group and the FOB group, respectively, p < 0.001. SEEKflex/videolaryngoscopy attenuated the incidence of postintubation complications. Conclusions SEEKflex/videolaryngoscopy can be used as an alternative to FOB in clinical practice when ATI is required due to the high rate of successful intubation at the first attempt, short intubation time, low complication rate and high patient satisfaction scores. Trial registration ChiCTR2300067555, 01/11/2023. |
| format | Article |
| id | doaj-art-8a7541773623429fbf2e11494df804f4 |
| institution | Kabale University |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj-art-8a7541773623429fbf2e11494df804f42025-08-20T04:03:00ZengBMCBMC Anesthesiology1471-22532025-07-012511710.1186/s12871-025-03229-1Comparison of SEEKflex/videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation: a randomized clinical trialWenyun Xu0Chenglong Zhu1Qinghua Wu2Bin Zhao3Miao Zhou4Yang Liu5Yongchu Hu6Jianhua Xia7Hongbin Yuan8Yaohua Yu9Zui Zou10School of Anesthesiology, Naval Medical UniversityFaculty of Anesthesiology, Changhai Hospital, Naval Medical UniversityDepartment of Anesthesiology, The First Hospital of Putian, Teaching Hospital of Fujian Medical UniversityDepartment of Anesthesiology, Shanghai Pudong New Area People’s HospitalDepartment of Anesthesiology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical UniversityFaculty of Anesthesiology, Changhai Hospital, Naval Medical UniversityDepartment of Anesthesiology, Changzheng Hospital, Naval Medical UniversityDepartment of Anesthesiology, Shanghai Pudong New Area People’s HospitalDepartment of Anesthesiology, Changzheng Hospital, Naval Medical UniversityDepartment of Anesthesiology, The First Hospital of Putian, Teaching Hospital of Fujian Medical UniversityFaculty of Anesthesiology, Changhai Hospital, Naval Medical UniversityAbstract Background Fibreoptic bronchoscope (FOB) is considered complex to learn and operate, and it remains controversial whether videolaryngoscopy can be used as an alternative to FOB for awake tracheal intubation (ATI). Aims The Objective is to compare the effectiveness of Safe Easy Endotracheal kit-flexible (SEEKflex)/video laryngoscopy and FOB in ATI. Methods We conducted a pragmatic, multicentre, non-blinded, randomized, parallel-group clinical trial in Shanghai and Putian, China. Between January 2023 and June 2024, patients aged 18–80 years who required ATI and were able to adapt to videolaryngoscopy were enrolled. We randomly assigned 148 patients who received ATI to two groups in a 1:1 ratio: SEEKflex/videolaryngoscopy group and FOB group. The rate of successful intubation at the first attempt was the primary outcome. Secondary endpoints were time to tracheal intubation; patient-reported satisfaction with the technique; and complications arising from intubation. Results Successful intubation at the first attempt was achieved in 69 cases (93%) using SEEKflex /videolaryngoscopy and only 58 cases (80%) using FOB, p = 0.015. The median (IQR [range]) time to tracheal intubation was 59 (51–66 [29–150]) s in the SEEKflex/videolaryngoscopy group and 92 (77–157 [40–869]) s in the FOB group, p < 0.001. The median (IQR [range]) scores for patient satisfaction were 8 (7–9 [4–10]) and 6 (4–7 [1–10]) in the SEEKflex/videolaryngoscopy group and the FOB group, respectively, p < 0.001. SEEKflex/videolaryngoscopy attenuated the incidence of postintubation complications. Conclusions SEEKflex/videolaryngoscopy can be used as an alternative to FOB in clinical practice when ATI is required due to the high rate of successful intubation at the first attempt, short intubation time, low complication rate and high patient satisfaction scores. Trial registration ChiCTR2300067555, 01/11/2023.https://doi.org/10.1186/s12871-025-03229-1Awake tracheal intubationSEEKflexFibreoptic bronchoscopeVideolaryngoscopyDifficult tracheal intubationAnaesthetists |
| spellingShingle | Wenyun Xu Chenglong Zhu Qinghua Wu Bin Zhao Miao Zhou Yang Liu Yongchu Hu Jianhua Xia Hongbin Yuan Yaohua Yu Zui Zou Comparison of SEEKflex/videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation: a randomized clinical trial BMC Anesthesiology Awake tracheal intubation SEEKflex Fibreoptic bronchoscope Videolaryngoscopy Difficult tracheal intubation Anaesthetists |
| title | Comparison of SEEKflex/videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation: a randomized clinical trial |
| title_full | Comparison of SEEKflex/videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation: a randomized clinical trial |
| title_fullStr | Comparison of SEEKflex/videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation: a randomized clinical trial |
| title_full_unstemmed | Comparison of SEEKflex/videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation: a randomized clinical trial |
| title_short | Comparison of SEEKflex/videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation: a randomized clinical trial |
| title_sort | comparison of seekflex videolaryngoscopy and fibreoptic bronchoscope for awake tracheal intubation a randomized clinical trial |
| topic | Awake tracheal intubation SEEKflex Fibreoptic bronchoscope Videolaryngoscopy Difficult tracheal intubation Anaesthetists |
| url | https://doi.org/10.1186/s12871-025-03229-1 |
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