A comparative study between conventional technique and tube first technique in awake nasotracheal fiberoptic intubation in difficult airway management

This is a prospective interventional study comparing the conventional technique and the tube-first technique in awake nasotracheal fibreoptic intubation in patients with anticipated difficult airway. Adult patients scheduled for elective surgery requiring awake nasotracheal fibreoptic intubation will be enrolled. Participants will be allocated to either the conventional technique group or the tube-first technique group. The primary outcome will be the success of intubation and time taken for successful awake nasotracheal fibreoptic intubation. Secondary outcomes will include ease of glottic visualization, number of attempts required for successful intubation, and procedure-related complications such as desaturation, bleeding, coughing, or failure of technique. The study aims to determine the safer and more effective technique for awake fibreoptic intubation in difficult airway management.