TO COMPARE THE INTUBATING CONDITIONS WITH DEXMEDETOMIDINE VERSUS MIDAZOLAM-FENTANYL COMBINATION FOR AWAKE FIBREOPTIC INTUBATION

Abstract

Objectives:To compare the intubating conditions of dexmedetomidine alone versus fentanyl -midazolam combination during AFOI\nMethodology: Group-I patients (n=30) received dexmedetomidine 1µg/kg bolus infusion over 10 minutes, followed by infusion of 0.1 µg/kg/hr\ntitrated to 0.7 µg/kg/hr whereas Group-II patients (n=30) received i.v fentanyl 2µg/kg bolus followed by midazolam infusion of 0.02-0.1mg/kg/hr\nuntil they were adequately sedated i.e. Ramsay Sedation Score (RSS) of 3 .Intraoperatively Total Comfort Score, 5 point FOI score was noted and\nQuestionnaire assessment was done 24 hours after surgery.\nResults: During preoxygenation, the mean TCS was not statistically signi\uf001cant different between the two groups but during FOS and during\nintubation, the mean TCS was lower in group-1than group-2and the difference between the two groups was statistically signi\uf001cant.(p<0.05).\nSigni\uf001cant differences in the patient s reaction to tube were found during FOS and after intubation between the two groups with lower reaction in\ndexmedetomidine group(p≤0.05). During follow-up assessment 24 hours after the surgical procedure, the dexmedetomidine group patients judged\ntheir sedation more positively and were having less pain and discomfort during the procedure than fentanyl plus midazolam patients.\nConclusion: The use of dexmedetomidine at 1mcg/kg bolus over 10 minutes, with maintenance rates of 0.1-0.7 μg/kg/hr offer better tolerance,\npreservation of a patent airway and spontaneous ventilation, while maintaining hemodynamic stability during AFOI.