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

Koung Shing Chua, Fu Yuan Wang, Hung Te Hsu, I. Cheng Lua, Hsun Mo Wang, Cheng Jing Tsai

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)

Abstract

Background and objective Dexmedetomidine is characterized with effects of sedation, analgesia, amnesia and lack of respiratory depression. Hence, it should be suitable for awake fibreoptic intubation (AFOI). Methods We enrolled 30 oral cancer patients with limited mouth openings who were undergoing AFOI for elective surgery. Patients were randomly allocated into two groups; the Dex group (nU16) that received dexmedetomidine (1.0mgkg-1) infusion and the Control group (nU14) that received fentanyl (1.0mgkg-1) infusion. Main outcomes were evaluated by grading scores presenting conditions for nasal intubation and postintubation. Other analysed parameters included airway obstruction, haemodynamic changes, consumption time for intubation, amnesia level and satisfaction. Results Intubation score (1-5) representing condition for nasal intubation was significantly better in the Dex group [2(1-3)] than in the Control group [3(2-5)] (PU0.001). Postintubation score (1-3) representing tolerance to intubation also showed more favourable results in the Dex group[1(1-3)] than intheControl group[2(2-3)] (PU0.002). The Dex group showed significantly reduced haemodynamic response to intubation than the Control group. Incidence requiring temporary haemodynamic support was higher in the Dex group but not of significance. Both levels of amnesia and satisfaction score were significant in the Dex group. Other analysed parameters such as consumption time for intubation, airway obstruction score and postoperative adverse events did not differ significantly. Conclusion 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.

Original languageEnglish
Pages (from-to)36-40
Number of pages5
JournalEuropean Journal of Anaesthesiology
Volume27
Issue number1
DOIs
Publication statusPublished - 2010 Jan

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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