What is it about?
Dexmedetomidine versus Propofol during a wake Fibre-optic Naso-tracheal Intubation
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Why is it important?
Awake fibreoptic intubation (AFOI) is often the preferred method for airway management in patients with difficult intubation. The success of AFOI is highly dependent on use of various sedatives, in addition to adequate preparation of airway. Although various pharmacological agents like fentanyl, ramifentanyl, midazolam, ketamine, propofol have been used for conscious sedation during AFOI, most of them have respiratory depressant effect in higher doses. Hence there is a need for an ideal sedative agent for AFOI that will not cause respiratory depression, also minimize undue discomfort and anxiety. The purpose of this study was to compare the effectiveness of Dexmeditomidine with propofol for conscious sedation during awakefibreopticnasotracheal intubation. Methods: Eighty patients with ASA (American society of anaesthesiology) physical status I and II, with age group between 18 to 55 years, were randomly divided into Dexmeditomidine (D) and Propofol (P)group. Patients with Group D were given intravenous Dexmeditomidine (n=40) 1µg /kg infusion over 10 mins. Group P were given propofol (n=40) 70 µg /kg min over 10 mins. Airway prepared by topical anaesthetic and airway blocks. Effectiveness of Dexmeditomidine and Propofol for patient’s intubating conditions , patient’s tolerance as graded by a scoring system, and hemodynamic changes were evaluated . Results: AFOI was successful in all patients. The patient’s comfort score was better in dexmditomodine group. The dexmeditomidine group experienced fewer airway events and less heart rate response to intubation than the propofol group.
Perspectives
Awake fibreoptic intubation (AFOI) is often the preferred method for airway management in patients with difficult intubation. The success of AFOI is highly dependent on use of various sedatives, in addition to adequate preparation of airway. Although various pharmacological agents like fentanyl, ramifentanyl, midazolam, ketamine, propofol have been used for conscious sedation during AFOI, most of them have respiratory depressant effect in higher doses. Hence there is a need for an ideal sedative agent for AFOI that will not cause respiratory depression, also minimize undue discomfort and anxiety. The purpose of this study was to compare the effectiveness of Dexmeditomidine with propofol for conscious sedation during awakefibreopticnasotracheal intubation. Methods: Eighty patients with ASA (American society of anaesthesiology) physical status I and II, with age group between 18 to 55 years, were randomly divided into Dexmeditomidine (D) and Propofol (P)group. Patients with Group D were given intravenous Dexmeditomidine (n=40) 1µg /kg infusion over 10 mins. Group P were given propofol (n=40) 70 µg /kg min over 10 mins. Airway prepared by topical anaesthetic and airway blocks. Effectiveness of Dexmeditomidine and Propofol for patient’s intubating conditions , patient’s tolerance as graded by a scoring system, and hemodynamic changes were evaluated . Results: AFOI was successful in all patients. The patient’s comfort score was better in dexmditomodine group. The dexmeditomidine group experienced fewer airway events and less heart rate response to intubation than the propofol group.
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This page is a summary of: Comparison of Effectiveness of Dexmedetomidine versus Propofol during a wake Fibre-optic Naso-tracheal Intubation, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.5518.27.
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