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Comparative Evaluation of Dexmedetomidine and Fentanyl as Adjuvant to Propofol on Intubation Conditions during Fiberoptic Intubation

Vikas Kumar Gupta, Assistant Professor, Department of Anaesthesiology, Gandhi Medical College, Bhopal, Madhya Pradesh 462001, India. , Sourabh Kumar1 , Vikas Kumar Gupta2 , Aditya Agarwal3

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Indian Journal of Anesthesia and Analgesia 4(4):p 1064-1069, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.25

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Abstract

Fiberoptic intubation (FOI) is recommended for patients with anticipated difficult airway, failed intubation, unstable cervical spine injurywhere optimum positioning for laryngoscopy is difficult to achieve. Fentany l, an opioid, is useful for fiberoptic intubation as it ensures mild sedation and analgesia with stable hemodynamics. Dexmedetomidine acts on presynaptic alpha2 receptors and results in sedation, hypnosis, amnesia, analgesia, anxiolysis, sympatholysis and antisialogogue. Aims: To compare the efficacy of Dexmedetomidine and Fentanyl as adjuvant to Propofol on intubating conditions during fiberoptic intubation. Materials and Methods: An observational, prospective clinical study was carried out on 60 patients of ASA grade I and II of either sex, aged 2060 yrs undergoing surgeries under general anaesthesia. Patients were allocated into two groups Group DD exmedetomidine group (n = 30) and Group FFentanyl group (n = 30). Intubation condition, post intubation score, depth of sedation, intubation time, any episode of hypoxia and hemodynamic changes were documented. Results: Satisfying intubation condition was procured in 27 subjects in group D as compared to 4 subjects in group F. Recommended postintubation score (= 1) was acquired in 23 Group D subjects in contrast to 3 Group F subjects. In group D, Ramsay sedation score obtained following conclusion of study drug infusion was notably high (3.230.352) as compared to Group F (2.020.262). Remarkable desaturation (SpO2 £ 94%) were encountered in 4 Group D subjects and 24 Group F subjects. Hemodynamic stability was also found more in group D. Conclusion: Dexmedetomidine by imparting superior intubation condition, stable hemodynamic parameters and appropriate sedation without desaturation is more efficacious as compared to Fentanyl when used for FOI. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.25

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