A Randomised Comparative Study of Dexmedetomidine v/s Fentanyl during awake Fibreoptic Nasotracheal intubation
A Randomised Comparative Study Of Dexmedetomidine V/S Fentanyl During Nasotracheal Intubation
Keywords:
Awake fibreoptic intubation, dexmedetomidine, FentanylAbstract
Introduction: AFOI is recommended in patients with anticipated difficult airway. Optimal intubating conditions, maintaining patent airway along with patient’s comfort are major hurdles. Ideal sedation regimen would provide patient comfort, obtundation of airway reflexes, hemodynamic stability, amnesia and maintenance of patent airway with spontaneous respiration. Method: 30 patients of each group with ASA grade 1 and 2 between 20-60 years were selected. Patients were divided in two groups receiving inj. Dexmedetomidine 0.5 μg/kg and inj Fentanyl 2 μg/kg respectively. Hemodynamic parameters, Success rate, Intubating conditions, sedation, hypoxial were analyzed. Results: Patients receiving dexmedetomidine had better hemodynamic stability, sedation, patient tolerance than fentanyl. Conclusion: Dexmedetomidine provide better fibreoptic intubation conditions than fentanyl however both provide optimal conditions without any significant complications. [Shah S NJIRM 2017; 8(1):116-119]
References
2. Cattano D, Lam NC, Ferrario L, Sietan C, Vahdat K, Wilcox D W, Hagberg CA. Dexmedetomidine versus Remifentanyl for sedation during awakefibreoptic intubation. Anaesthesiology Research and parctice2012;1-7.
3. Chalam KS.A comparative study of intravenous dexmedetomidine versus propofol based sedation for awake fibreoptic intubation along with airway blocks in cervical discectomy patients. KarnatakaAnaesth J 2015;1:21-27.
4. Tsai CJ, Chu KS, Chen KI, Lu DV, Wang HM, Lu IC. A comparison of the effectiveness of dexmedetomidine versus propofol target controlled infusion for sedation during fibreoptic nasotracheal intubation. Anaesthesia2010; 27:211-7.
Singh P, Punia TS, Kaur B, Ramachandriah P, Kaur J, Kumar D.A randomised clinical study of dexmedetomidine and midazolam for sedation during awake fibreoptic intubation in laparoscopic cholecystectomy patients. Int J Clin Trials 2015 ; Feb2(1):1-9.
6. Gupta K, Jain M, Gupta PK, Rastogi B, Saxena SK, Manngo A. Dexmedetomidine premedication for fiberoptic intubation in patients of temporomandibular joint ankylosis: A randomized clinical trial. Saudi Journal of Anaesthesia. 2012;6(3):219-223. doi:10.4103/1658-354X.101211.
7. Chu KS, Wang FY, Hsu HT, Lu IC, Wang HM, Tsai CJ. The effectiveness of dexmedetomidine infusion for sedating oral cancer patients undergoing awakefibreoptic nasal intubation. Eur J Anaesthesiol 2010; 2
8. Bergese SD, Khabiri B, Roberts WD, Howie MB, McSweeney TD, Gerhardt MA. Dexmedetomidine for conscious sedation in difficult awake fibreoptic intubation cases. J ClinAnaestg 2007; 19:141-4.
9. Ryu, J H, Lee S W, Lee, J. H, Lee E H.,Do, S H, Kim, CS. Randomized double-blind study of remifentanil and dexmedetomidine for flexible bronchoscopy.Bja2011;4007:36-40
10. Grant SA, Breslin DS, MacLeod DB, Gleason D, Martin G. Dexmedetomidine infusion for sedation during fiberoptic intubation: A report of three cases. J ClinAnesth 2004;16:124-6.
11. Maroof M, Knan RM, Jain D,Ashraf M. Dexmedetomidine is a useful adjunct for awake intubation. Can J Anaesth2005 ;52:776-7
12. Abdelmalak B, Makary L, Hoban J,Doyle DJ. Dexmedetomidine as sole sedative for awake intubation in management of critical airway. J ClinAnaesth 2007; 19:370-3
13. Avitsian R, Lin J, Lotto M, EbrahimZ.Dexmedetomidine and awake fibreoptic intubation for possible cervical spine myelopathy: A clinical series. J NeurosurgAnaesthesiol 2005;17:97-9
