INTRODUCTION:Awake Fibreoptic Intubation is indicated in patients with anticipated diffcult airway, failed tracheal
intubation, unstable cervical spine injury.Drugs used for conscious sediation includes Benzodiazepines, opioids,
Propofol, either alone or in combination. All these drugs, though results in favourable intubating conditions, may also result in upper airway
obstruction, hypoventilation, difcult airway instrumentation and oxygen desaturation. In order to address and overcome these issues, we
compared the effects of parenteral dexmedetomidine and fentanyl on favourable conditions during awake breoptic bronchoscopic intubation.
MATERIALS AND METHODS:A prospective,double blind,randomised study. 60 patients belonging to age group 25 to 60 years, ASA PS I &
II posted for elective surgery under general anaesthesia with endotracheal intubation were randomly allocated into two groups, Group A(n=30)
received injection dexmedetomidine, Group B(n=30) received injection fentanyl before awake breoptic bronchoscopic intubation.
Hemodynamic parameters, cough score, postintubation tolerance score, ramsay sedation score were noted in both groups. The observed datas
were analysed by SPSS version 21.0 software.
RESULT: Demographic variable such as age,weight,ASA physical status were comparable in both the groups. The mean heart rate at
5mins,10mins after administration of study drug,intubation, 5mins postintubation are 76.73±5.51,73.63±5.99,76.37±8.11 and 75.03±7.94
respectively in Group A.The mean heart rate at 5mins,10mins after administration of study drug,intubation, 5mins postintubation are
78.57±5.04,76.93±5.11,103.30±4.21 and 99.37±4.02 respectively.The mean MAP at 5mins,10 mins after administration of study
drug,intubation,5 mins post intubation are 86.80±2.33,85.77 ±2.56,87.83 ±5.73 and 87.30 ± 2.52mmHg respectively in Group A.The mean
MAP at 5mins,10mins after administration of study drug,intubation,5 mins post intubation are 87.37±3.58,85.63 ±3.58,107.80 ±2.59 and 105.00
±2.52 mmHg respectively. The post intubation SpO2 was 97.10 ±1.77 and 93.43± 1.17 % for Group A and Group B respectively.In Group A
mean Ramsay sedation score is 2.87± 0.43 and in Group B the mean is 2.13 ±0.35.
CONCLUSION:Dexmedetomidine group showed better hemodynamic stability and tolerance to awake endotracheal tube insertion through
breoptic bronchoscope.Dexmedetomidine provides favourable intubating conditions during awake breoptic bronchoscope procedures with
adequate sedation and without desaturation than fentanyl.
