Comparative Study Between Dexmedetomidine and Fentanyl as Sedatives in Awake Fiberoptic Intubation in Cervical Spine Surgeries

• Published in: QJM : An International Journal of Medicine Vol. 114; no. Supplement_1
• Main Authors: El Mageed, Waleed Mohamed Abd, Ali, Ahmad Kamal Mohamed, Bayoumi, Eeman Aboubakr ElSiddik Ahmed, Omar, Haitham Sabry Mahmoud
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.10.2021
• Subjects: dexmedetomidine; Awake intubation; fentanyl
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcab086.033

Abstract Background Various drugs are used for providing favorable intubation conditions during awake fiberoptic intubation (AFOI). However, most of them have various side effects. Aim The aim of this study was to compare the effects of dexmedetomedine and fentanyl as regards sedative effects, hemodynamic stability, intubation time and intubation attempts success during awake fiberoptic intubation. Material and Methods A randomized double-blind prospective study was conducted on a total of 40 patients scheduled for elective cervical spine surgeries who were randomly allocated into two equal groups (n 20): (group A) patients received a bolus dose of dexmedetomidine of 1 mcg/kg over 10 min followed by a continuous infusion of dexmedetomidine at 0.5 mcg/kg/h. and fentanyl group (group B) received dose of 1 μg/kg over 10 min followed by 0.5 μg/kg/hr. Sedation score (Ramsy sedation score), hemodynamic variables, oxygen saturation, intubation time and intubation attempts were noted and compared between the two groups. Results Ramsy Sedation Score was significantly favorable (P < 0.001) in group A in comparison to group B, moreover better hemodynamic stability during intubation (P < 0.05) and less intubation attempts were observed in group A in comparison to group B. Conclusion The results of our study showed that dexmedetomidine provides optimum sedation without compromising airway or hemodynamic stability and with favorable intubation time and less intubation attempts during AFOI in comparison to fentanyl.