RESEARCH PAPER
Year : 2019  |  Volume : 10  |  Issue : 1  |  Page : 11-15

Comparison of safety and efficacy of dexmedetomidine versus propofol sedation for elective awake fiber-optic intubation


1 Department of Anaesthesiology, AIIMS, Raipur, Chhattisgarh, India
2 Department of Anaesthesiology, NEIGRIHMS, Shillong, Meghalaya, India

Correspondence Address:
Tridip Jyoti Borah
Department of Anaesthesiology, NEIGRIHMS, Shillong - 793 018, Meghalaya
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpp.JPP_71_18

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Objective: To evaluate the safety and efficacy of dexmedetomidine versus propofol as a sedative modality for awake fiber-optic intubation (AFOI) in elective patients with anticipated difficult intubation. Materials and Methods: This randomized prospective study was conducted on 90 patients (Group D and Group P; n = 45) who had undergone AFOI for anticipated difficult airway. Group D received intravenous (IV) dexmedetomidine and Group P patients received IV propofol, until they were adequately sedated. Sedation was measured by Bispectral index© and Ramsay Sedation Scale. Airway blocks were given to all patients undergoing awake fiber-optic intubation. Intubation comfort scores, airway obstruction scores, and hemodynamics were recorded in all patients. Results: Sedation level was comparable in both the groups. Intubation time was less in Group D than Group P (119.06 ± 16.51 s vs. 126.67 ± 18.19 s; P < 0.05). The intubation score for both cough and vocal cord opening was better in the dexmedetomidine group than the propofol group (P = 0.6). There were significant incidences of airway obstruction and hypoxia in Group P compared to Group D (P < 0.05). Significant fall in mean arterial pressure (MAP) was seen in Group P during drug infusion which continued till fiber-optic bronchoscopy (P < 0.05). MAP changes during intubation were similar during intubation in both the groups (P = 0.18). Conclusion: Dexmedetomidine is a better alternative for achieving optimal sedation during AFOI.


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