دورية أكاديمية
Hemodynamic Responses and Safety of Sedation Following Premedication with Dexmedetomidine and Fentanyl during Fiberoptic-assisted Intubation in Patients with Predicted Difficult Airway.
| العنوان: | Hemodynamic Responses and Safety of Sedation Following Premedication with Dexmedetomidine and Fentanyl during Fiberoptic-assisted Intubation in Patients with Predicted Difficult Airway. |
|---|---|
| المؤلفون: | Rajan S; Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India., Talukdar R; Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India., Tosh P; Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India., Paul J; Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India., Vasu BK; Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India., Kumar L; Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India. |
| المصدر: | Anesthesia, essays and researches [Anesth Essays Res] 2018 Jan-Mar; Vol. 12 (1), pp. 11-15. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Medknow Publications Country of Publication: India NLM ID: 101578762 Publication Model: Print Cited Medium: Print ISSN: 0259-1162 (Print) Linking ISSN: 22297685 NLM ISO Abbreviation: Anesth Essays Res Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Mumbai] : Medknow Publications |
| مستخلص: | Background: Awake fiberoptic intubation (AFOI) is the gold standard for the management of predicted difficult airway, and inappropriate sedation is a major cause leading to its failure. Aims: The primary objective was to compare the heart rate (HR) changes that accompany AFOI following sedation with dexmedetomidine and fentanyl. Secondary objectives included comparison of changes in blood pressure, patient comfort, ease of intubation, and degree of sedation. Settings and Designs: This prospective double-blinded randomized study was conducted in a tertiary care institution. Subjects and Methods: Forty patients with anticipated difficult airway requiring AFOI were included in the study. Group A received dexmedetomidine 1 μg/kg whereas Group B received fentanyl 2 μg/kg. After topical anesthesia of the airway, AFOI was performed. Statistical Analysis Used: Fisher's exact test, independent two-sample t -test, and Mann-Whitney U -test were used as applicable. Results: The hemodynamic parameters were comparable in both the groups except at 1 min postintubation when fentanyl group had significantly higher HR. There were lower alertness and muscle tone scores in dexmedetomidine group. Total comfort score was significantly higher in fentanyl group. Though more patients in dexmedetomidine group showed that no reaction to intubation and more patients in fentanyl had slight grimacing, the difference was insignificant. The ease of intubation was similar in both the groups. Conclusion: Though dexmedetomidine1 μg/kg and fentanyl 2 μg/kg premedication results in comparable hemodynamics and ease of intubation, in view of enhanced patient comfort, dexmedetomidine premedication is advantageous in patients with anticipated difficult airway undergoing AFOI. Competing Interests: There are no conflicts of interest. |
| References: | Can J Anaesth. 2009 Sep;56(9):683-701. (PMID: 19636657) J Maxillofac Oral Surg. 2014 Mar;13(1):53-8. (PMID: 24644397) J Clin Anesth. 2010 Feb;22(1):35-40. (PMID: 20206849) J Anaesthesiol Clin Pharmacol. 2015 Apr-Jun;31(2):212-6. (PMID: 25948903) J Thorac Dis. 2013 Jun;5(3):270-7. (PMID: 23825758) J Clin Psychopharmacol. 1990 Aug;10(4):244-51. (PMID: 2286697) Respir Care. 2014 Jun;59(6):865-78; discussion 878-80. (PMID: 24891196) J Pediatr Psychol. 1992 Feb;17(1):95-109. (PMID: 1545324) J Maxillofac Oral Surg. 2010 Dec;9(4):377-81. (PMID: 22190828) Anesthesiology. 2013 Feb;118(2):251-70. (PMID: 23364566) J Craniofac Surg. 2015 Jan;26(1):206-9. (PMID: 25478975) Saudi J Anaesth. 2012 Jul;6(3):219-23. (PMID: 23162393) Can J Anaesth. 2013 Jun;60(6):584-99. (PMID: 23512191) |
| فهرسة مساهمة: | Keywords: Conscious sedation; dexmedetomidine; fentanyl; fiberoptic; hemodynamics; intubation; premedication |
| تواريخ الأحداث: | Date Created: 20180410 Latest Revision: 20220316 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC5872845 |
| DOI: | 10.4103/aer.AER_176_17 |
| PMID: | 29628546 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 0259-1162 |
|---|---|
| DOI: | 10.4103/aer.AER_176_17 |