Clinical application of dexmedetomidine as a sole sedative used in maxillofacial surgery for awake fiberoptic intubation in patients with difficult airways

Objective: To observe the clinical effects of dexmedetomidine(Dex) used in maxillofacial surgery for awake intubation in patients with difficult airways.Methods: 40 patients were randomly and equally divided into two groups.Patients in group A received Dex at loading of dose 1 μg/kg for 10 minutes with the rate of 6 μg/(Kg·h);those in group B received midazolam 2 mg and fentanyl 0.05 mg.When the patients' expression of alertness/sedation(OAA/S) reached to 3,and BIS was less than 85,patients in the two groups were received enough topical anesthetics to the airway.Then awake fiberoptic intubation was administered.OAA/S,HR,MAP,SPO2 as well as BIS were recorded before drug administration(T0),when OAA/S reached to 3 and BIS was less than 85(T1),success of intubation(T2) and 5 minutes after intubation(T3);serum level of norepinephrine(NE) and epinephrine(E) were measured at T0 and T3.The total dose of Dex application quantity along with patients' cooperation of intubation and amnesia was recorded.Results: HR in group A slowed down obviously and it was less than in group B after using the drug(P0.05).BP in the two groups rised after intubation(P0.05),SPO2 in the two groups lowered after using the drugs and was higher in group A than in group B(P0.05),serum NE and E in the two groups increased significantly,but in group A it was lower than in group B(P0.05).Conclusion: Dex has desirable sedation and analgesia effects and may be used alone for awake intubation alone.Attention should be paid for the prevention of bradycardia.