The effectiveness of dexmedetomidine infusion for sedating oral cancer patients undergoing awake fibreoptic nasal intubation

Abstract

Combination of dexmedetomidine loading with topical anaesthesia provides significant benefit for AFOI in intubation condition, patient tolerance, haemodynamic response, amnesia and satisfaction. Dexmedetomidine is effective for AFOI in anticipated difficult airway with only minor and temporary haemodynamic adverse effects.

Effect of Multiple Doses of Dexmedetomidine for Moderate Sedation Facilitating Intubation during Nasotracheal Fiberoptic Laryngoscope in Awake Patients-A Randomized Prospective Study

“…However, a study assumed by Grendelmeier P et al on propofol and midazolam as sedative agents concluded that patients received propofol showed more profound hypotension [29]. Chu et al assumed that a loading dose 1 μg/kg of intravenous dexmedetomidine provided conscious sedation without airway obstruction or respiratory depression for fiberoptic intubation which was the same with our study [30]. Dexmedetomidine assumed privileges of adequate sedation without narcotic-induced respiratory depression.…”

Conscious sedation for awake fibreoptic intubation: a review of the literature

“…The DEX group had better intubating conditions and patient tolerance of the procedure and less hemodynamic response to intubation with minimal adverse effects. 45 Again, it is not surprising that this study found in favour of the hemodynamic outcomes of dexmedetomidine when the dose of fentanyl used in the comparator group was less than that used by Ovassapian et al in combination with midazolam (1.56 lgÁkg -1 and 0.12 mgÁkg -1 , respectively). When they reported increases of C20 mmHg in mean arterial pressure and C20 beatsÁmin -1 in heart rate in 30% of their patients.…”

“…29,[43][44][45] Level 1 evidence for the efficacy and safety of dexmedetomidine for AFOI is provided by five RCTs. Tsai et al randomized 40 patients needing AFOI to either dexmedetomidine (1.0 lgÁkg -1 ) or propofol TCI (effect-site concentration 3.6 lgÁmL -1 ) (see above and Table 2).…”

Conscious Sedation and Awake Fiberoptic Intubation in a Patient with Difficult Mask Ventilation—A Case Report

“…In addition, dexmedetomidine decreases salivary secretion through sympatholytic and vagomimetic effects, which is advantageous for fiberoptic intubation [10] [11]. Furthermore, dexmedetomidine provided an optimal intubating condition, less hemodynamic instability and better patient tolerance [12] [13]. Dexmedetomidine thus has many properties that make it suitable for AFOI, and it has been highly recommended for AFOI.…”