Comparative efficacy of inhaled glycopyrrolate and intravenous glycopyrrolate for optimizing awake fibreoptic intubation conditions in adult patients a double blind randomized controlled trial

Awake fibreoptic intubation AFOI is a cornerstone of airway management in patients with anticipated difficult intubation such as those with limited mouth opening cervical spine instability or upper airway tumours

This is a double blind randomised controlled trial aims to address this gap by comparing the efficacy of inhaled glycopyrrolate versus intravenous glycopyrrolate in decreasing secretions

The study hypothesizes that nebulized glycopyrrolate may improve the fiberoptic view of upper airway and glottis by effectively suppressing airway mucus secretion thereby decreasing cough enhancing patient comfort and facilitating faster tracheal intubation

Inhaled glycopyrrolate is primarily used for chronic obstructive pulmonary disease COPD management due to its bronchodilator effects

It offers the advantage of localized airway effects without significant systemic side effects

Limited studies suggest that inhaled glycopyrrolate may provide effective secretion control for AFOI while reducing systemic anticholinergic side effects

There is a paucity of studies comparing inhaled and intravenous glycopyrrolate specifically in the context of AFOI

If inhaled glycopyrrolate proves effective it may offer an alternative with fewer systemic side effects and better patient comfort

This study will provide evidence to guide anaesthetic practice in optimizing AFOI conditions