Comparison of Two Sedation Regimens for Awake Fiberoptic Intubation

This study compares two different sedation methods used when patients need to be awake during a breathing tube placement — a procedure known as awake fiberoptic intubation (AFOI). This technique is used when a patient's airway is expected to be difficult to manage under general anesthesia, requiring the tube to be placed while they are conscious but comfortable. The study tests whether a new sedation drug combination works as well as or better than the current standard approach in keeping patients calm and cooperative while maintaining their ability to breathe. Adults aged 18 and older who have been identified as having a potentially difficult airway and are scheduled for awake fiberoptic intubation are eligible. The identification of eligible patients happens through the surgical schedule and pre-operative assessments by anesthesia teams. Participants receive one of the two sedation regimens before and during the procedure. Both approaches are already in clinical use; the study simply compares their outcomes in terms of patient comfort, safety, and procedure success rates. This research matters because awake intubation can be a stressful and uncomfortable experience. Finding the best sedation approach can improve patient safety and experience, especially in high-risk airway situations where maintaining the patient's protective reflexes is critical.