A Comparative Study between Local Dexmedetomidine and Intravenous Dexmedetomidine during Awake Fiberoptic...

Area of Science:

• Anesthesiology
• Airway Management
• Pharmacology

Background:

• Awake fiberoptic intubation (AFOI) is the standard for difficult airway management.
• Sedative medications like dexmedetomidine are used to improve patient cooperation.
• Intravenous sedatives may cause respiratory depression and hypoxia.

Purpose of the Study:

• To compare the efficacy of nebulized/transtracheal versus intravenous dexmedetomidine for AFOI.
• Primary endpoint: Patient Tolerance Score (PTS).
• Secondary endpoints: Sedation score, cough score, and procedure duration.

Main Methods:

• Prospective, randomized, double-blind study.
• 76 adult patients undergoing elective AFOI.
• Group I: Intravenous dexmedetomidine (1 μg/kg).
• Group L: Nebulized (0.5 μg/kg) and transtracheal (0.5 μg/kg) dexmedetomidine.

Main Results:

• Nebulized/transtracheal dexmedetomidine yielded significantly higher PTS and lower cough scores (P < 0.05).
• Procedure duration was significantly shorter with nebulized/transtracheal administration (P < 0.05).
• No significant difference in hemodynamic parameters or sedation scores between groups (P > 0.05).

Conclusions:

• Nebulized and transtracheal dexmedetomidine provide superior patient tolerance and reduced coughing during AFOI compared to the intravenous route.
• This approach optimizes conditions for AFOI, enhancing patient comfort and procedural outcomes.