Intravenous sedation for fiberoptic intubation:comparison of propofol vs. midazolam/alfentanil

Falkman, H.; Lemogne, M; Boughezala, Samia; Choufane, S.; Eurin, B

doi:10.1097/00003643-200100001-00024

Cited by 3 publications

(7 citation statements)

References 2 publications

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“…Falkman H et al assumed that propofol shows more homogeneous satisfaction score [26].There were variations found in heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure among the two groups but it was statistically insignificant. These findings are similar to the studies conducted by Falkman H et al, Crawford M et al and Clarkson K et al, who found statistically insignificant difference in hemodynamics parameters among propofol and midazolam groups during fiberoptic laryngoscopy [26][27][28]. However, a study assumed by Grendelmeier P et al on propofol and midazolam as sedative agents concluded that patients received propofol showed more profound hypotension [29].…”

Section: Discussionmentioning

confidence: 98%

Effect of Multiple Doses of Dexmedetomidine for Moderate Sedation Facilitating Intubation during Nasotracheal Fiberoptic Laryngoscope in Awake Patients-A Randomized Prospective Study

Arafa¹,

ElSayed²

2017

J Anesth Clin Res

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Background: Nasal fiberoptic intubation in fully conscious patients is the gold standard technique of choice in known difficult airway as cervical instability, limited mouth opening and any facial defects. The usage of an ideal sedation agent with a perfect dose or regimen securing stability of hemodynamic conditions and optimizing the intubating condition at the same time is an indispensable demand for awake fiberoptic intubation.

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Section: Discussionmentioning

confidence: 98%

Effect of Multiple Doses of Dexmedetomidine for Moderate Sedation Facilitating Intubation during Nasotracheal Fiberoptic Laryngoscope in Awake Patients-A Randomized Prospective Study

Arafa¹,

ElSayed²

2017

J Anesth Clin Res

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“…No significant differences in the hemodynamic parameters were found in previous similar studies done by various authors. [ 3 4 ]…”

Section: Discussionmentioning

confidence: 99%

“…Similar results matching as that of our study were found in other studies done by various authors. [ 3 4 5 6 ]…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of propofol versus midazolam in fiberoptic endotracheal intubation

et al. 2016

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Background:Fiberoptic intubation is a technique commonly used for difficult airways. Conscious sedation is desirable to make this procedure tolerable, and it is essential that patients are cooperative, relaxed, and comfortable especially when difficult airway anatomy or pathology is encountered.Objective:To compare the safety and efficacy of propofol versus midazolam in oral fiberoptic endotracheal intubation in terms of hemodynamic changes, level of sedation, ease of intubation, and patient comfort and complications.Materials and Methods:In a prospective randomized study, 60 patients of age group 18–60 years and American Society of Anesthesiologists health classification of I and II with anticipated difficult intubation were randomly allocated into two groups. Both the groups were premedicated with injection glycopyrrolate 0.005 mg/kg and injection butorphanol 1 mg and nebulized with 4 ml of 4% lignocaine starting 20 min before the surgery. After that patients in Group I received intravenous propofol 1–2 mg/kg to a maximum of 2 mg/kg followed by 20 mg increments if needed and Group II received 0.05 mg/kg midazolam followed by 2 mg increments till the adequate level of sedation was reached. Patients were monitored for hemodynamic parameters, sedation according to observer's assessment of alertness score, intubation score, intubation time, patient comfort, satisfaction score, and complications, if any. Results were statistically analyzed.Results:The mean sedation score, patient comfort score, and patient satisfaction were greater in propofol group (P < 0.05) but there were no significant differences in hemodynamics, intubating conditions, and complications.Conclusion:We conclude that compared with midazolam, propofol provides better sedation for fiberoptic endotracheal intubation and better patient comfort and satisfaction.

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Efficacy of adding low-dose ketamine to dexmedetomidine versus low-dose ketamine and propofol for conscious sedation in patients undergoing awake fiber-optic intubation

Sharkawy

2019

Anesth Essays Res

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Background and Aims: Conscious sedation is the key for successful AFOI. This trial was conducted to compare the effectiveness of dexmedetomidine and low dose of ketamine against propofol and low dose ketamine. Materials and Methods: Sixty patients subjected for general anesthesia were invited to participate in the study and randomly allocated into two equal groups: D-K ( n = 30) had been received a bolus dose of both ketamine 0.5mg /kg and dexmedetomidine 1ug/kg over 10 min. Then continuous infusion of ketamine 0.5mg /kg and dexmedetomidine 1ug/kg. The second group (P-K group) ( n = 30): had been received a bolus dose of both ketamine 0.5mg/kg and propofol 1mg/kg over 10 min. Then continuous infusion of ketamine 0. 5mg/kg and propofol 1mg/kg. Results: The intubation time was statistically significant shorter within the D-K group (58.9 ± 6.1) versus P-K group (63.4 ± 5.3) with p-value 0.02. The shorter time needed to achieve the OAA/S score = 2 was in the D-K group (2.25 ± 0.75) versus (2.9 ± 0.79) in P-K group with ( P -value 0.004). The intubation scores were insignificant different between both groups except vocal cord opening which was statistical better among D-K group with P -value 0.03. The significant hypotensive recorded data were among P-K group while the decreased heart rate were recorded in D-K group. Eighty percentages of patients had excellent score of satisfaction within the D-K gp against 47% among the patients within P-K gp with P -value 0.01. Conclusion: The concomitant administration of low dose of ketamine with dexmedetomidine had better intubation time and sedation scores with higher patient satisfaction scores than the combination of propofol and low dose of ketamine.

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Intravenous sedation for fiberoptic intubation:comparison of propofol vs. midazolam/alfentanil

Cited by 3 publications

References 2 publications

Effect of Multiple Doses of Dexmedetomidine for Moderate Sedation Facilitating Intubation during Nasotracheal Fiberoptic Laryngoscope in Awake Patients-A Randomized Prospective Study

Effect of Multiple Doses of Dexmedetomidine for Moderate Sedation Facilitating Intubation during Nasotracheal Fiberoptic Laryngoscope in Awake Patients-A Randomized Prospective Study

Efficacy and safety of propofol versus midazolam in fiberoptic endotracheal intubation

Efficacy of adding low-dose ketamine to dexmedetomidine versus low-dose ketamine and propofol for conscious sedation in patients undergoing awake fiber-optic intubation

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