Comparison of Dexmedetomidine and Nalbuphine on Intubating Conditions and Hemodynamic Responses During Awake Fiberoptic Intubation: A Randomized Study
Background: The pre-requisites to a successful awake fiberoptic intubation (AFOI) include adequate psychological and pharmacological preparation of the patient. This study aims to compare two pharmacological agents, dexmedetomidine and nalbuphine, in addition to nebulization and airway topicalizati...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2023-07-01
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| Series: | Archives of Anesthesia and Critical Care |
| Subjects: | |
| Online Access: | https://aacc.tums.ac.ir/index.php/aacc/article/view/624 |
| _version_ | 1797630534232309760 |
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| author | Sujata Chaudhary R C Ananth Swati Bharti Rashmi Salhotra Mahendra Kumar |
| author_facet | Sujata Chaudhary R C Ananth Swati Bharti Rashmi Salhotra Mahendra Kumar |
| author_sort | Sujata Chaudhary |
| collection | DOAJ |
| description |
Background: The pre-requisites to a successful awake fiberoptic intubation (AFOI) include adequate psychological and pharmacological preparation of the patient. This study aims to compare two pharmacological agents, dexmedetomidine and nalbuphine, in addition to nebulization and airway topicalization, for intubating conditions during AFOI.
Methods: Sixty consenting patients belonging to ASA I/II, MPC I/II, age-group of 18-60 years weighing between 40-70 kgs requiring general anaesthesia with endotracheal intubation were randomly allocated to one of the two groups. Patients received dexmedetomidine 1µg/kg i.v. (group D) or nalbuphine 0.2 mg/kg i.v. (group N) over 10 min before intubation. Fiberoptic intubation was attempted. Intubating conditions were assessed in terms of sedation score, cough score and post-intubation score. Hemodynamic responses, lignocaine and propofol requirement were also recorded. Repeated measure ANOVA, Tukey’s test, unpaired t test, Chi‑square test or Fisher’s exact test were used for data analysis. A P < 0.05 was considered significant.
Results: Sedation score (P = 1.000), cough score (P = 0.165) and post‑intubation score (P = 0.157) were comparable among the two groups. Hemodynamic responses, propofol and lignocaine requirements were also comparable.
Conclusion: Both intravenous dexmedetomidine and nalbuphine provide good intubating condition with minimal adverse effects on haemodynamic profile during awake fibreoptic intubation.
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| first_indexed | 2024-03-11T11:09:29Z |
| format | Article |
| id | doaj.art-700b9a415ced45069aa58a413aab0877 |
| institution | Directory Open Access Journal |
| issn | 2423-5849 |
| language | English |
| last_indexed | 2024-03-11T11:09:29Z |
| publishDate | 2023-07-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Archives of Anesthesia and Critical Care |
| spelling | doaj.art-700b9a415ced45069aa58a413aab08772023-11-12T06:52:34ZengTehran University of Medical SciencesArchives of Anesthesia and Critical Care2423-58492023-07-019Supplement10.18502/aacc.v9i5.13955Comparison of Dexmedetomidine and Nalbuphine on Intubating Conditions and Hemodynamic Responses During Awake Fiberoptic Intubation: A Randomized StudySujata Chaudhary0R C Ananth1Swati Bharti2Rashmi Salhotra3Mahendra Kumar4Department of Anesthesiology and Intensive Care, VMM College and SJ Hospital, IP University, Delhi, India.Department of Critical Care Medicine, Manipal Hospitals, Bengaluru, India.Department of Anesthesiology, Pain Medicine and Critical Care, AIIMS, JPNATC, Delhi, India.Department of Anesthesiology and Critical Care, UCMS and GTB Hospital, Delhi University, Delhi, India.Department of Anesthesiology and Critical Care, Sharda Medical School and Research (SMSR), Sharda University, Greater Noida, UP, India. Background: The pre-requisites to a successful awake fiberoptic intubation (AFOI) include adequate psychological and pharmacological preparation of the patient. This study aims to compare two pharmacological agents, dexmedetomidine and nalbuphine, in addition to nebulization and airway topicalization, for intubating conditions during AFOI. Methods: Sixty consenting patients belonging to ASA I/II, MPC I/II, age-group of 18-60 years weighing between 40-70 kgs requiring general anaesthesia with endotracheal intubation were randomly allocated to one of the two groups. Patients received dexmedetomidine 1µg/kg i.v. (group D) or nalbuphine 0.2 mg/kg i.v. (group N) over 10 min before intubation. Fiberoptic intubation was attempted. Intubating conditions were assessed in terms of sedation score, cough score and post-intubation score. Hemodynamic responses, lignocaine and propofol requirement were also recorded. Repeated measure ANOVA, Tukey’s test, unpaired t test, Chi‑square test or Fisher’s exact test were used for data analysis. A P < 0.05 was considered significant. Results: Sedation score (P = 1.000), cough score (P = 0.165) and post‑intubation score (P = 0.157) were comparable among the two groups. Hemodynamic responses, propofol and lignocaine requirements were also comparable. Conclusion: Both intravenous dexmedetomidine and nalbuphine provide good intubating condition with minimal adverse effects on haemodynamic profile during awake fibreoptic intubation. https://aacc.tums.ac.ir/index.php/aacc/article/view/624Airway managementAwake fiberoptic intubationDexmedetomidineDifficult airwayNalbuphine |
| spellingShingle | Sujata Chaudhary R C Ananth Swati Bharti Rashmi Salhotra Mahendra Kumar Comparison of Dexmedetomidine and Nalbuphine on Intubating Conditions and Hemodynamic Responses During Awake Fiberoptic Intubation: A Randomized Study Archives of Anesthesia and Critical Care Airway management Awake fiberoptic intubation Dexmedetomidine Difficult airway Nalbuphine |
| title | Comparison of Dexmedetomidine and Nalbuphine on Intubating Conditions and Hemodynamic Responses During Awake Fiberoptic Intubation: A Randomized Study |
| title_full | Comparison of Dexmedetomidine and Nalbuphine on Intubating Conditions and Hemodynamic Responses During Awake Fiberoptic Intubation: A Randomized Study |
| title_fullStr | Comparison of Dexmedetomidine and Nalbuphine on Intubating Conditions and Hemodynamic Responses During Awake Fiberoptic Intubation: A Randomized Study |
| title_full_unstemmed | Comparison of Dexmedetomidine and Nalbuphine on Intubating Conditions and Hemodynamic Responses During Awake Fiberoptic Intubation: A Randomized Study |
| title_short | Comparison of Dexmedetomidine and Nalbuphine on Intubating Conditions and Hemodynamic Responses During Awake Fiberoptic Intubation: A Randomized Study |
| title_sort | comparison of dexmedetomidine and nalbuphine on intubating conditions and hemodynamic responses during awake fiberoptic intubation a randomized study |
| topic | Airway management Awake fiberoptic intubation Dexmedetomidine Difficult airway Nalbuphine |
| url | https://aacc.tums.ac.ir/index.php/aacc/article/view/624 |
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