Clinical observation of dexmedetomidine for intubation in patients with potential difficult airways

Objective To evaluate the efficacy of dexmedetomidine for awake intubation in patients with potential difficult airways.Methods 40 patients with mallampatti grade of Ⅲ~Ⅳ were randomly divided into two groups:dexmedetomidine group(group D,n=20)and control group(group C,n=20).In group D,dexmedetomidine 1 μg/kg was infused during 15 min.In group C,patients received midazolam 1 mg and fentanyl 0.05~0.1 mg.All patients were given enough topical anesthetics with 1% dicaine in upper respiratory tract.Then awake intubation with fiberoptic bronchoscope was conducted.BP,HR,SpO2,BIS and OAA/S were recorded before drug infusion(T1),at the end of infusion(T2),before intubation(T3)and success of intubation(T4).Patients′ memory about intubation was recorded at the first postoperative day.Results In group D,HR was significantly lower at T2 than those at T1 and at T4(P0.05).In group C,SBP was lower at T3 than at T1(P0.05),and HR was higher at T4 than at T3(P0.05).Compared with group C,SBP at T2 and T3 were significantly higher in group D(P0.05),and HR at T2 and T4 were significantly lower(P0.05).There was no significant difference in SpO2,BIS and OAA/S between the two groups.The rate of memory was higher in group D(P0.05).Conclusion Dexmedetomidine provides stable hemodynamics and desirable sedation during awake intubaton in patients with potential difficult airways.