Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation Full Text
Anesthesiology Research and Practice, 07/18/2012
Cattano D et al. – Dexmedetomidine seems a useful adjunct for patients undergoing awake fiberoptic intubation (AFOI) but is dependent on dosage and time.Methods
- Thirty–four adult ASA I–III patients were enrolled in a double–blinded randomized pilot study to receive remifentanil (REM) or dexmedetomidine (DEX) for sedation during AFOI (nasal and oral).
- Thirty patients completed the study and received 2mg midazolam IV and topical anesthesia.
- The REM group received a loading dose of 0.75mcg/kg followed by an infusion of 0.075mcg/kg/min.
- The DEX group received a loading dose of 0.4mcg/kg followed by an infusion of 0.7mcg/kg/hr.
- Time to sedation, number of intubation attempts, Ramsay sedation scale (RSS) score, bispectral index (BIS), and memory recall were recorded.
- All thirty patients were successfully intubated by AFOI (22 oral intubations/8 nasal).
- First attempt success rate with AFOI was higher in the REM group than the DEX group, 72% and 38% (0.02), respectively.
- The DEX group took longer to attain RSS of ≥3 and to achieve BIS <80, as compared to the REM group.
- Postloading dose verbal recall was poorer in the DEX group.