English

Abstract

Fibreoptic intubation is a valuable modality for airway management. This study aimed to compare the efficacy and safety of dexmedetomidine and propofol infusion for sedation during fibreoptic nasotracheal intubation. Twenty patients of either sex aged between 18 to 60 years belonging to ASA I or ASA II grade were enrolled and randomly allocated into the dexmedetomidine group (1.0 μg/kg infusion over 10 min followed by 0.5 µg/kg/hr. during fibreoptic nasotracheal intubation) (n = 10) and the propofol group (100µg/kg/min body weight over 10 min followed by 50µg/kg/min during fibreoptic nasotracheal intubation) (n = 10). Intubating conditions and patient tolerance as graded by a scoring system were evaluated as primary outcomes. Intubation was successful in all patients. Satisfactory intubating conditions were found in both groups (10/10 in each group). In the evaluation of efficacy it was found that dexmedetomidine group had better patient tolerability according to 5 point fibreoptic intubation comfort score (3.0±1.05 and 1.8±1.03 in propofol and dexmedetomidine group respectively (p<0.05)). In the evaluation of safety it was found that in dexmedetomidine group better Spo2 is maintained during intubation (p<0.05), there was significant decrease in diastolic blood pressure in propofol group at the end of infusion (p<0.05) and there was significant decrease in pulse rate in dexmedetomidine group than propofol group at the end of infusion (p<0.05). Both drugs infusion are effective and safe to be used as sedative agent during fibreoptic nasotracheal intubation with same incidence of amnesia but better patient tolerance and Spo2 maintenance with dexmedetomidine.