To Evaluate the Comparison of Intubating Conditions Using Fentanyl Plus Propofol Versus Nalbuphine Plus Propofol During Fiberoptic Intubation

Abstract

BACKGROUND Awake nasal or oral flexible fiberoptic intubation (AFOI) is the airway management technique of choice in known or anticipated difficult airway, severe cervical stenosis, Chiari malformation, unstable cervical fracture, limited mouth opening as in temporomandibular disease, mandibular-maxillary fixation, severe facial burn and vertebral artery insufficiency. [1] Fiberoptic intubation is the best, easiest and most successful method for awake intubation. MATERIALS AND METHODS A prospective, comparative and randomized study was conducted on 100 patients undergoing elective surgery under general anaesthesia. Patients were randomly divided into two groups of 50 each. Group I: Patient received bolus of I.V. fentanyl 1 ug/kg+ propofol 1 mg/kg so as to achieve an adequate level of sedation i.e. RSS=3. Group II: Patient received bolus of I.V. nalbuphine 0.2 mg/kg + propofol 1 mg/kg to achieve adequate level of sedation. Haemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure), SpO2, EtCO2, total comfort scale and patient's tolerance were assessed during preoxygenation, fiberscope insertion and endotracheal intubation. RESULTS Significant difference (p<0.05) between two groups in terms of HR, SBP, DBP, MAP, total comfort score and patient tolerance was seen during fiberscope insertion and endotracheal intubation. CONCLUSION Fentanyl plus propofol regimes are suitable for fiberoptic intubation. Fentanyl plus propofol appeared to offer better tolerance, preservation of an airway and spontaneous ventilation, while maintaining haemodynamic stability.