Evaluation of intubating conditions using dexmedetomidine - fentanyl combination versus dexmedetomidine alone for awake nasal fiberoptic intubation
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 1
Abstract
Aims and Objective: Awake fiberoptic intubation is one of the principal techniques of intubation in patients with difficult airway. The aim of our study was to compare the effectiveness of Dexmedetomidine- Fentanyl combination with Dexmedetomidine alone, for sedation and intubating conditions without respiratory depression, in patients with difficult airway undergoing awake nasal fiberoptic intubation. Material and Method: 60 patients with difficult airway, age group 18-60 years, of either sex ,belonging to American Society of Anaesthesiologist Physical status (ASA PS) I and II posted for elective surgeries under general anaesthesia were randomly allocated into two groups (30 each). Group D received infusion of Inj Dexmedetomidine 1µg /kg i.v diluted upto 50 ml over 10 min and Group DF received Inj Dexmedetomidine 1 µg /kg i.v with Inj Fentanyl 1 µg /kg i.v diluted upto 50 ml infused over 10 mins. Sedation score (RSS), Cough score, Patient comfort score, intubation time and attempts were noted during awake nasal fiberoptic intubation, along with hemodynamic parameters (heart rate, mean arterial pressure, arterial oxygen saturation) and side effects of drugs, if any. Results: Sedation score was comparable in both the groups (p=0.182). Cough score, patient comfort score and intubation time were significantly better (p<0.0001) in Group DF. Similarly hemodynamic parameters were better in Group DF than Group D. No adverse effects such as transient hypertension, asystole, airway obstruction, laryngospasm, apnea, severe hypoxia (< 90%) were seen in either of the group. Conclusion: Low dose Dexmedetomidine- Fentanyl (1µg /kg each) infusion provides effective sedation, excellent intubating conditions, good hemodynamic stability without airway compromise.
Authors and Affiliations
S P Sikchi, R G Alapure, S A Chaudhari
Keywords
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- DOI 10.26611/10159115
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