Abstract No.: ABS0322: COMPARISON OF PROPOFOL AND DEXMEDETOMIDINE SEDATION FOR AWAKE C-MAC D-BLADE VIDEO-LARYNGOSCOPIC INTUBATION IN DIFFICULT AIRWAY CASES

Abstract

Background & Aims:Safest method for securing difficult airway is awake intubation. Aim is to compare propofol and dexmedetomidine for C-MAC D-blade guided difficult intubation under conscious sedation. A prospective, interventional, two arm, randomised study including 60 American Society of Anesthesiologists (ASA )grade I-III patients.Methods:After nasal packing, local anaesthesia, IV midazolam 0.03mg.kg-1and IV fentanyl 1µg.kg-1, in Group-P, propofol was infused at rate of 250 µg.kg.-1min-1, and in Group-D, dexmedetomidine 1 µg g.kg-1 over 10 min, then 0.5 µg .kg.-1h-1, till BIS values 65-70. Patients underwent C-MAC D-blade video-laryngosope guided intubation. Quantitative variables were compared using unpaired t-test/Mann-Whitney Test between groups and paired t-test/Wilcoxon ranked sum test across follow- up within the group. Qualitative variables were correlated using Chi-Square test/Fisher`s exact test. A p-value of <0.05 was considered statistically significant. Data was analysed by Statistical Package for Social Sciences (SPSS) version 24.Results:The mean intubation score was higher in the dexmedetomidine group (4.4) [propofol group (3.6)]. Patient reaction to intubation and haemodynamic parameters were more favourable in the propofol group. Coughing and vocal cord movementwas comparable. Time to achieve desired BIS-value was 4 times longer and time to intubate was six seconds longer indexmedetomidine group. Percentage of Glottic Opening (POGO)scores were slightly better in the propofol group. Propofol group was comparatively complication free.Conclusion:Successful awake video-laryngoscopic intubation using the C-MAC D-blade can be performed in patients in both groups.Propofol gives a better intubation score and haemodynamic stability than dexmedetomidine.