Comparison of Safety and Efficacy of Dexmedetomidine versus Propofol Sedation for Elective Awake Fiber-optic Intubation
Samarjit Dey1, Tridip Jyoti Borah2★, Jaideep Sonowal2, Debasis Pradhan2, Md. Yunus2, Priyanka Dev2★ Corresponding author
- 1Department of Anaesthesiology, AIIMS, Raipur, Chhattisgarh, India.
- 2Department of Anaesthesiology, NEIGRIHMS, Shillong, Meghalaya, India.
CORRESPONDENCE
Tridip Jyoti Borah
Department of Anaesthesiology, NEIGRIHMS, Shillong - 793 018, Meghalaya, India.
Received: 14-07-2018; Revised: 27-10-2018; Accepted: 05-01-2019.
Volume 10, Issue 1 · pp. 11–15 · PUBLISHED 2019 · DOI: 10.4103/jpp.JPP_71_18
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ABSTRACT
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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Dey, S., Borah, T. J., Sonowal, J., Pradhan, D., Yunus, M., & Dev, P. (2019). Comparison of Safety and Efficacy of Dexmedetomidine versus Propofol Sedation for Elective Awake Fiber-optic Intubation. Journal of Pharmacology and Pharmacotherapeutics, 10(1), 11–15. https://doi.org/10.4103/jpp.JPP_71_18