Abstract :
Background: Awake fibreoptic intubation (AFOI) is a great aid in an anticipated difficult airway like in
maxillofacial surgeries. For providing patient’s comfort and cooperation various drugs are used. In this
study we evaluated efficacy of Dexmedetomidine and Fentanyl for sedation during AFOI.
Materials and Methods: It is randomized prospective double blind study. It was conducted on patients
electively posted for maxillofascial surgery. 60 patients were randomly divided in two groups. Group D
received Dexmedetomidine 1mg/kg and Group F received Fentanyl 2mg/kg over 10 minutes. Patients from
both groups were prepared with intravenous glycopyrrolate0.2mg and nebulization with 4% lidocaine 4ml.
Nasal AFOI was performed with spray (10% lidocaine) as you go technique. Parameters analysed are
intubation score by cough score and vocal cord movement, post intubation score, Ramsay sedation score,
hemodynamics with incidence of desaturation. Also satisfaction score and time taken for intubation were
compared in 2 groups.
Result: Cough score, vocal cord movement, postintubation score, Ramsay Sedation Score (RSS), patient
satisfaction score were favourable in dexmedetomidine group without much difference in time taken for
intubation in both groups. Minimum hemodynamic response (p value
(p value< 0>
Conclusion: Dexmedetomidine appeared to offer better intubation condition, better tolerance to intubation
with higher patient satisfaction and hemodynamic stability. Also it provides adequate sedation without
desaturation making it more effective for AFOI than fentanyl.
Keyword :
AFOI, Dexmedetomidine, Fentanyl.