Comparison of the safety and efficacy of propofol and dexmedetomidine as sedatives when used as a modified topical formulation

Abstract

Purpose: To evaluate the safety and efficacy of propofol and dexmedetomidine as sedatives in patients with anticipated difficult airways, used as a modified topical preparation.Methods: A total of 432 patients were enrolled in this study. They were classified as ASA I and ASA II. The patients were equally divided into group A (propofol group) and group B (dexmedetomidine group). A modified Awake Fiberoptic Intubation (AFOI) was carried out for these patients, followed by airway assessment and evaluation of clinical outcome based on intubation scores, adverse events, and postoperative data.Results: Patients in both groups had successful intubation at the first attempt. There was no significant difference in baseline characteristics between the two groups. The SARI scores which characterized the overall score for tracheal intubation were 4.6 and 4.2 for groups A and B, respectively. With respect to rescue infusion and consciousness, 11 patients (5.09 %) in group A required rescue, as against 5 patients (2.31 %) in group B. Seven (7) patients (3.24 %) in group A (propofol group) had severe airway obstruction, while only 4 patients (1.85) in group B had the same adverse reaction. Patients in group B had more satisfactory and favourable outcomes than those in group A who were treated with modified AFOI.Conclusion: The use of dexmedetomidine based on modified topical anaesthesia is safe and comfortable in terms of patient convenience and difficult airway management. Thus, dexmedetomidine is a safe, feasible and effective method for managing difficult airway when applied using the modified AFOI.