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

Related Articles

Efficacy of bupivacaine infiltration for postoperative pain relief in paediatric patients

Background: The effective control of pain remains one of the most important issues in the postoperative care today. Local infiltration of bupivacaine requires less skill and is better technique for postoperative pain rel...

A comparative study between ketamine nebulization and betamethasone gel applied over the endotracheal tube cuff for reduction of post-operative sore throat

Background: Endotracheal intubation is necessary in general anesthesia (GA) to control respiration and to protect airway. Larynx and trachea are the most common sites of injury during intubation and usually manifested as...

Efficacy of dexmedetomidine as an anaesthetic adjuvant for functional endoscopic sinus surgery under general anaesthesia: A randomized controlled study (of 50 cases)

Functional endoscopic sinus surgery (FESS) is one of the commonly performed Surgeries for acute and chronic sinus pathologies and nasal polyps. Dexmedetomidine is highly selective Alpha 2 agonist acts by central mechanis...

Comparison of levobupivacaine and clonidine with plain levobupivacaine in spinal anaesthesia in lower limb surgeries

Background: Intrathecal Levobupivacaine is having similar clinical profile with less cardio-toxicity than Bupivacaine is used commonly in lower limb surgeries. Clonidine as an additive to LA provides effective prolongati...

Pre-emptive analgesic effects of paracetamol infusion versus intramuscular ketorolac in patients undergoing elective laparoscopic cholecystectomy: A comparative study

Background: Minimally invasive surgery has displayed advantages over open surgery but still causes mild to moderate post-operative pain. Preemptive analgesia is one of the strategies of pain management which has beneficia...

Download PDF file
  • EP ID EP520904
  • DOI 10.26611/10159115
  • Views 172
  • Downloads 0

How To Cite

S P Sikchi, R G Alapure, S A Chaudhari (2019). Evaluation of intubating conditions using dexmedetomidine - fentanyl combination versus dexmedetomidine alone for awake nasal fiberoptic intubation. Medpulse International Journal of Anesthesiology, 9(1), 68-73. https://europub.co.uk/articles/-A-520904