Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation
This study compared remifentanil and dexmedetomidine as awake fiberoptic intubation (AFOI) anesthetics. 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). Thi...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/753107 |
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| author | Davide Cattano Nicholas C. Lam Lara Ferrario Carmen Seitan Kash Vahdat Darrell W. Wilcox Carin A. Hagberg |
| author_facet | Davide Cattano Nicholas C. Lam Lara Ferrario Carmen Seitan Kash Vahdat Darrell W. Wilcox Carin A. Hagberg |
| author_sort | Davide Cattano |
| collection | DOAJ |
| description | This study compared remifentanil and dexmedetomidine as awake fiberoptic intubation (AFOI) anesthetics.
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 2 mg midazolam IV and topical anesthesia. The REM group received a loading dose of 0.75 mcg/kg followed by an infusion of 0.075 mcg/kg/min. The DEX group received a loading dose of 0.4 mcg/kg followed by an infusion of 0.7 mcg/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% (P=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. Dexmedetomidine seems a useful adjunct for patients undergoing AFOI but is dependent on dosage and time. Further studies in the use of dexmedetomidine for AFOI are warranted. |
| format | Article |
| id | doaj-art-f21e7ba642da4c4ba458cbb19a28c2b9 |
| institution | Kabale University |
| issn | 1687-6962 1687-6970 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anesthesiology Research and Practice |
| spelling | doaj-art-f21e7ba642da4c4ba458cbb19a28c2b92025-02-03T06:11:45ZengWileyAnesthesiology Research and Practice1687-69621687-69702012-01-01201210.1155/2012/753107753107Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic IntubationDavide Cattano0Nicholas C. Lam1Lara Ferrario2Carmen Seitan3Kash Vahdat4Darrell W. Wilcox5Carin A. Hagberg6Department of Anesthesiology, The University of Texas Medical School at Houston, Houston, TX 77030, USADepartment of Anesthesiology, The University of Texas Medical School at Houston, Houston, TX 77030, USADepartment of Anesthesiology, The University of Texas Medical School at Houston, Houston, TX 77030, USADepartment of Anesthesiology, The University of Texas Medical School at Houston, Houston, TX 77030, USADepartment of Internal Medicine, Vanderbilt University, Nashville, TN 37240, USADepartment of Anesthesia, Duke University School of Medicine, Durham, NC 27710, USADepartment of Anesthesiology, The University of Texas Medical School at Houston, Houston, TX 77030, USAThis study compared remifentanil and dexmedetomidine as awake fiberoptic intubation (AFOI) anesthetics. 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 2 mg midazolam IV and topical anesthesia. The REM group received a loading dose of 0.75 mcg/kg followed by an infusion of 0.075 mcg/kg/min. The DEX group received a loading dose of 0.4 mcg/kg followed by an infusion of 0.7 mcg/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% (P=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. Dexmedetomidine seems a useful adjunct for patients undergoing AFOI but is dependent on dosage and time. Further studies in the use of dexmedetomidine for AFOI are warranted.http://dx.doi.org/10.1155/2012/753107 |
| spellingShingle | Davide Cattano Nicholas C. Lam Lara Ferrario Carmen Seitan Kash Vahdat Darrell W. Wilcox Carin A. Hagberg Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation Anesthesiology Research and Practice |
| title | Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation |
| title_full | Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation |
| title_fullStr | Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation |
| title_full_unstemmed | Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation |
| title_short | Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation |
| title_sort | dexmedetomidine versus remifentanil for sedation during awake fiberoptic intubation |
| url | http://dx.doi.org/10.1155/2012/753107 |
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