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. 2015 Apr-Jun;31(2):212-6.
doi: 10.4103/0970-9185.155151.

Comparison between dexmedetomidine and fentanyl on intubation conditions during awake fiberoptic bronchoscopy: A randomized double-blind prospective study

Sudeshna Mondal  1 , Sarmila Ghosh  1 , Susmita Bhattacharya  1 , Brojen Choudhury  1 , Suchismita Mallick  1 , Anu Prasad  1
Affiliations

Comparison between dexmedetomidine and fentanyl on intubation conditions during awake fiberoptic bronchoscopy: A randomized double-blind prospective study

Sudeshna Mondal et al. J Anaesthesiol Clin Pharmacol. 2015 Apr-Jun.

Abstract

Background and aims: Various drugs are used for providing favorable intubation conditions during awake fiberoptic intubation (AFOI). However, most of them cause respiratory depression and airway obstruction leading to hypoxemia. The aim of this study was to compare intubation conditions, and incidence of desaturation between dexmedetomidine and fentanyl group during AFOI.

Material and methods: This randomized double-blind prospective study was conducted on a total of 60 patients scheduled for elective laparotomies who were randomly allocated into two groups: Group A received dexmedetomidine 1 mcg/kg and Group B received fentanyl 2 mcg/kg over 10 min. Patients in both groups received glycopyrrolate 0.2 mg intravenous, nebulization with 2% lidocaine 4 ml over 20 min and 10% lidocaine spray before undergoing AFOI. Adequacy of intubation condition was evaluated by cough score and post-intubation score. Incidence of desaturation, hemodynamic changes and sedation using Ramsay sedation scale (RSS) were noted and compared between two groups.

Results: Cough Score (1-4), post-intubation Score (1-3) and RSS (1-6) were significantly favorable (P < 0.0001) along with minimum hemodynamic responses to intubation (P < 0.05) and less oxygen desaturation (P < 0.0001) in Group A than Group B.

Conclusion: Dexmedetomidine is more effective than fentanyl in producing better intubation conditions, sedation along with hemodynamic stability and less desaturation during AFOI.

Keywords: Awake intubation; dexmedetomidine hydrochloride; fentanyl citrate.

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Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Rosenblatt WH. Airway management. In: Barash PG, Cullen BF, Stoelting RK, et al., editors. Clinical Anesthesia. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. pp. 595–638.
    1. Bergese SD, Khabiri B, Roberts WD, Howie MB, McSweeney TD, Gerhardt MA. Dexmedetomidine for conscious sedation in difficult awake fiberoptic intubation cases. J Clin Anesth. 2007;19:141–4. - PubMed
    1. Lallo A, Billard V, Bourgain JL. A comparison of propofol and remifentanil target-controlled infusions to facilitate fiberoptic nasotracheal intubation. Anesth Analg. 2009;108:852–7. - PubMed
    1. Rai MR, Parry TM, Dombrovskis A, Warner OJ. Remifentanil target-controlled infusion vs propofol target-controlled infusion for conscious sedation for awake fibreoptic intubation: A double-blinded randomized controlled trial. Br J Anaesth. 2008;100:125–30. - PubMed
    1. Bailey PL, Pace NL, Ashburn MA, Moll JW, East KA, Stanley TH. Frequent hypoxemia and apnea after sedation with midazolam and fentanyl. Anesthesiology. 1990;73:826–30. - PubMed