Video Laryngoscope Versus a USB Borescope Aided Endotracheal Intubation in Adults With Anticipated Difficult Airway

For patients allocated to the USB-borescope technique, a proper size endotracheal tube will be placed over the USB-borescope (with an external diameter of 5.5 mm) which will be coated externally with water-soluble lubricant. The proper size laryngoscope blade will be inserted. The USB-borescope will be placed through the oral cavity and will be advanced while tracking it on a mobile phone, it will be advanced to the glottic opening. If needed, rotation of USB-borescope and/or external laryngeal manipulation will be used to align it with the vocal cord.

For patients allocated to the intubation over Video Laryngoscope technique, video laryngoscope (Insighters insight is3) proper size blade will be placed and introduction of the Video Laryngoscope till viewing the glottis opening then insertion of a proper sized endotracheal tube

Inclusion Criteria:

• 1.American Society of Anesthesiologist ASA physical status I-II patients. 2.Both genders. 3.Age18-60 years old 4.BMI <35 5.patients with El-Ganzouri score more than or equal to 4

Exclusion Criteria:

• Presence of pulmonary diseases
• Uncontrolled hypertension
• Ischemic heart disease
• Cervical spine fracture
• Limited mouth opening
• known to have tumors or polyps in the upper airway
• History of difficult intubation or difficult bag-mask ventilation
• Patients with difficult bag-mask ventilation after induction of anesthesia