Dexmedetomidine provides optimum conditions during awake fiberoptic intubation in cervical spine injury patients

Dr.L.Parthasarathy; Dr.G.K.Kumar; Dr.N.Basker; Dr.Subramani

Volume : VIII, Issue : VI, June - 2018

Dexmedetomidine provides optimum conditions during awake fiberoptic intubation in cervical spine injury patients

Dr. L. Parthasarathy, Dr. G. K. Kumar, Dr. N. Basker, Dr. Subramani

Abstract :

Background and Aims:

We undertook this study to assessdexmedetomidine (DEX) for conscious sedation during fiberoptic intubation (FOI) in cervical spine injury.The aim was to assess the efficacy of DEX on arousability and patient‘s comfort during FOI in CSI patients.

Material and Methods:

In this observational study, 50 American Society of Anesthesiologists Grade I–II patients aged between 18 and 65 years scheduled for elective surgery under general anesthesia underwent FOI under conscious sedation with DEX. After locally anesthetizing the airway and applying a cervical collar, patients received DEX 1 μg/kg over 10 min followed by 0.7 μg/kg/h maintenance infusion in normal saline during FOI. Sedation (Ramsay sedation score [RSS] ) during FOI was recorded.

Results:

The total number of patients succesfuly fio optically intubated with DEX were 42. In remaining 8 patients additional sedation agents like Midazolam or Propofol were used to perform fioptic intubation. These 8 cases were excluded from this study. The mean sedation score was sedation (RSS ≥3) . Similarly, patient satisfaction score, heart rate, systolic, diastolic and mean arterial pressure and respiratory parameters were observed during the procedure.

Conclusions:

Dexmedetomidine provides optimum sedation without compromising airway or hemodynamic instability and better patient tolerance and satisfaction in 84% for FOI.In 12% of patients additional sedation agents were required to perform FOI.