Application of dezocine and dexmedetomidine in awake fiberoptic bronchoscopy intubation

Abstract

Objective To study the sedation-analgesia effect and safety of the application of dezocine and dexmedetomidine in awake fiberoptic bronchoscopy intubation at intensive care unit. Methods 180 patients needing intubation and mechanical ventilation at the intensive care unit of our hospital from January, 2015 to December, 2016 were randomly divided into group A, group B, and group C, 60 for each group. Group A administered midazolam 0.1 mg/kg before intubation, group B dezocine 0.1 mg/kg and midazolam 0.05 mg/kg, and group C dezocine 0.1 mg/kg and dexmedetomidine 1 μg/kg. The data of heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), and saturation of pulse oxygen (SpO2) were collected and compared before intubation (T1), during intubation (T2), and 10 minutes after intubation (T3). Motor Activity Assessment Scale (MAAS) and Ramsay score were used to evaluate the sedation-agitation effect during intubation and 10 minutes after intubation respectively; and the APACHEⅡ scores were collected to classify the severities of disease. Results In all the three groups, the HR at T3 was significantly lower than that at T1 [group A: (99.0±5.2) beats/min vs. (101.2±7.6) beats/min, P 0.05). At T2, the MAP of group C was significantly lower than those of group A and group B [(68.4±8.1) mmHg vs. (73.6±8.6) mmHg, P 0.05). After intubation, the Ramsay score was lower in group A than in group B and group C [(2.4±0.9) vs. (2.7±0.9), P 0.05). Conclusion Better intubation tolerance and sedative effect could be acquired by the administration of dezocine with midazolam or dexmedetomidine than the administration of midazolam alone. The administration of dezocine and dexmedetomidine in awake patients undgoing fiberoptic bronchoscopy intubation could provide a reliable sedation and analgesia effect. Key words: Fiberoptic bronchoscopy intubation; Dezocine; Midazolam; Dexmedetomidine.