Dexmedetomidine vs Fentanyl for Awake Fiberoptic Intubation in Paediatric Patients with Temporomandibular Joint Ankylosis: A Retrospective Analysis
Introduction: For successful management of difficult paediatric airway intubation, proper preparation of airway along with a calm and sedated child with titrated doses of sedative agents is paramount. Aim: To compare two different classes of sedative agents (Dexmedetomidine vs Fentanyl) regardi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/14466/47295_CE[Ra1]_F[SK]_PF1(ShG_KM)_PFA(ShG_KM)_PN(SHU).pdf |
| Summary: | Introduction: For successful management of difficult paediatric
airway intubation, proper preparation of airway along with a
calm and sedated child with titrated doses of sedative agents
is paramount.
Aim: To compare two different classes of sedative agents
(Dexmedetomidine vs Fentanyl) regarding intubating conditions
and comfort score of paediatric population at the time of awake
fiberoptic intubation.
Materials and Methods: This retrospective study was carried
out among 40 paediatric patients, aged between 5-14 years
those who underwent surgery for Temporo-Mandibular Joint
(TMJ) ankylosis. Clinical data relevant for this study was
collected from the pre-format sheets of anaesthesia technique,
attached with case files of the patients. Inj. dexmetedomidine
bolus of 1 mcg/kg for 10 minutes followed by infusion at the rate
0.6 mcg/kg/hr in group A and Inj. fentanyl bolus dose of 2 mcg/
kg followed by infusion 1 mcg/kg/hr in group B were compared
in terms of intubating conditions and patient co-operation. For
data analysis Statistical Package for the Social Sciences (SPSS)
version 20 (IBM Inc.) was used. Patient characteristics in the two
groups were compared using mean±SD and chi-square test.
Results: All the patients had successful intubation in first attempt
in both the groups. In terms of airway preparation, out of total,
14 (35%) patients in group A had no secretions as compare to
4 (10%) patients of group B (p-value was 0.002). In terms of
cough score, 13 (32.5%) patients in group A had no cough as
compared to 3 (7.5%) patients in group B. Patients in group
A were more comfortable at the time of insertion of Flexible
Fiberoptic Bronchoscopy (FOB) with no or less resistance to
FOB insertion (p-value was 0.043). Vocal cord conditions were
favourable in both the groups and there was no difference.
Conclusion: Fiberoptic nasal intubation was found to be
easier and safe in terms of patient comfort and preservation of
patent airway with the use of dexmedetomidine, in paediatric
TMJ ankylosis. |
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| ISSN: | 2249-782X 0973-709X |