Application of dexmedetomidine target-controlled infusion for sedation during awake fibreoptic nasotracheal intubation

【Objective】To investigate the efficacy of dexmedetomidine controlled infusion for awake fibreoptic nasotracheal intubation. 【Methods】 Forty patients with anticipated difficult airways and underwent tracheal intubation for elective surgery were enrolled and randomly allocated into the dexmedetomidine group (1.0 μg/kg over 10 min) (n=20) or remifentanil group (after intravenous injection of midazolam 0.05 mg/kg then controlled infusion of remifentanil 1.5μg/kg target controlled infusion, n =20). 【Results】Compared with R group, MAP and SPO2 in D group had no significantly differences at T1, T2 (P0.05). Compared with T0, HR at T1 obviously decreased in both groups (P0.05), there were no significantly differences of MAP at T0, T1 and T2, then compared with T0 and T1, HR at T2 obviously increased. Intubation was successful in all patients. The incidence of respiratory inhibition was lower in the D group compared with R group (P0.05), patient satisfaction did not differ significantly between the two groups. 【Conclusions】Controlled infusion of dexmedetomidine over 10 min decreases heart rate response to intubation without respiratory inhibition, which provides a safe and good intubation condition for awake fibreoptic nasotracheal intubation.