Dexmedetomidine for the management of fibreoptic intubation

He, Xing‐Ying; Shi, Xueyin

doi:10.1002/14651858.cd009798

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…The main purpose of medication during AFOBI is to keep patients responsive and cooperative without respiratory and cardiovascular function depression [6,19]. To achieve these effects, the agent used must have an immediate onset of action, be easily titratable, and produce adequate sedation [20].…”

Section: Discussionmentioning

confidence: 99%

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Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial

Peng

Sun

et al. 2020

Preprint

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Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine (DEX) is a selective α-2-adrenoceptor agonist that has the ability to sedate, functions as an anxiolysis, is analgesic sparing, and reduces salivary secretion [6]. It can induce a 'wakable' state that is similar to normal sleep.…”

Section: Introductionmentioning

confidence: 99%

Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial

Peng

Sun

et al. 2020

Preprint

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“…The main purpose of medication during AFOBI is to keep patients responsive and cooperative while preventing potential respiratory and cardiovascular function depression [6,21]. To achieve this, the anesthetic agents used during the procedure must have a fast onset of action, be easily titratable while providing adequate sedation [22].…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine (DEX) is a selective α-2-adrenoceptor agonist that has the ability to sedate, functions as an anxiolysis, is analgesic sparing, and reduces salivary secretion [6]. It can induce a 'awakable' state that mimics the physiological sleep state.…”

mentioning

confidence: 99%

Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial

Peng

Sun

et al. 2020

Preprint

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Background: Awake fiberoptic bronchoscope intubation (AFOBI) is the gold standard technique for the management of patients with difficult airways. Adequate sedation and analgesia are essential for successful AFOBI. The aim of this study was to evaluate the sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation.Methods: Patients undergoing head and neck surgery under general anesthesia with predicted difficult airways were included. Participants were randomly assigned to 6 different groups (n = 6): groups 1-3 were intravenous (IV), while groups 4-6 were intranasal (IN) (group 1: dexmedetomidine (DEX) 1 μg/kg + fentanyl (FEN) 1 μg/kg; groups 2-3: DEX 1 μg/kg + FEN 0.7 μg/kg + ketamine (KTM) 0.1/0.2 mg/kg; group 4: DEX 1.5 μg/kg + FEN 1.4 μg/kg; and groups 5-6: DEX 1 μg/kg + FEN 1 μg/kg + KTM 0.4/0.6 mg/kg). The visual analog scale (VAS) score during intubation, time required for the modified observer’s assessment of alertness/sedation scale (OAA/S) score to reach above 2 and for the bispectral index (BIS) to decrease to 60-80, motor activity assessment scale (MAAS) score, changes in vital signs and adverse effects were recorded.Results: Among the IV groups, the VAS score of group 1 (5.65 ± 2.11) was higher than those of group 2 (1.89 ± 2.16, P = 0.012) and group 3 (1.15 ± 0.98, P = 0.001). Among the IN groups, the VAS score was lower in group 6 (0.86 ± 1.27) than in group 4 (7.20 ± 2.70, P < 0.001) and group 5 (3.93 ± 2.73, P = 0.031). Participants in group 5 and group 6 were less likely to cough when intubated than those in group 4 (P = 0.002), while the differences among IV groups were not significant. There were no significant differences in the other endpoints.Conclusions: Our study indicates that the addition of subanesthetic doses of ketamine, either intravenous or intranasal, could reduce the fentanyl and dexmedetomidine consumption used in AFOBI and provide better sedative and analgesic effects.Trial registration: Chinese Clinical Trial Registry (www.chictr.org.cn; ChiCTR1900021185), prospectively registered on February 1st, 2019.

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“…Currently used sedation agents for fibreoptic intubation include fentanyl , propofol , sufentanil (SUF) , remifentanil and dexmedetomidine (DEX) . DEX, a selective alpha 2‐adrenoceptor agonist, is of interest because it possesses sedative, anxiolytic, analgesic and sympatholytic properties during awake intubation, without depressing respiratory function .…”

Section: Introductionmentioning

confidence: 99%

Comparison of dexmedetomidine and sufentanil for conscious sedation in patients undergoing awake fibreoptic nasotracheal intubation: a prospective, randomised and controlled clinical trial

Shen

Xie

Wang

et al. 2013

Clinical Respiratory J

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Dexmedetomidine for the management of fibreoptic intubation

Cited by 7 publications

References 18 publications

Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial

Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial

Sedative and analgesic validity and administration routes of dexmedetomidine and fentanyl combined with ketamine in awake fiberoptic intubation: An exploratory randomized controlled trial

Comparison of dexmedetomidine and sufentanil for conscious sedation in patients undergoing awake fibreoptic nasotracheal intubation: a prospective, randomised and controlled clinical trial

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