Application of dexmedetomidine in difficult airway patients with blind tracheal intubation

Objective To assess the value of dexmedetomidine in difficult airway patients receiving awake nasotracheal intubation with blind intubation device under topical anesthesia.Methods Fifty patients with difficult airway from oral maxillofacial department were randomly divided into two groups (n=25).The patients in dexmedetomidine group received intravenous injection of 1.0 μg/kg dexmedetomidine for 10 mins at 15 mins before intubation (T0).The patients in midazolam group received intravenous injection of 0.02 mg/kg midazolam and 2 μ/kg fentanyl at 5 mins before intubation (t0).Awake nasotracheal intubation was applied with blind intubation device.The success rates of intubation,intubation time,and heart rate (HR),mean arterial pressure (MAP),saturation pulse oxygen (SpO2),respiratory rate (RR) and observer's assessment of alertness/sedation (OAA/S) score at the time point of T0 or t0,T1 (immediately after inserting lightwand) and T2 (immediately after inserting the tracheal tube guided by lightwand) were observed.Results There were no significant differences in age,gender,body mass inder (BMI),success rates of intubation or intubation time between the two groups (all P0.05).HR at T1 and T2 in dexmedetomidine group were significantly lower than those in midazolam group (all P0.01).Compared with those in midazolam group at T1,RR was significantly increased and OAA/S score was significantly decreased in dexmedetomidine group (P0.05).There was no significant difference of MAP at each time point between the two groups (P0.05).SpO2 maintained at 95% to 100% during intubation in both two groups.Conclusion Under the induction of dexmedetomidine,stable hemodynamics and ideal sedation can be achieved in patients receiving awake nasotracheal intubation with blind tracheal device.(Shanghai Med J,2012,35:994-997)