THE EFFECT OF COMBINED DEXMEDETOMIDINE WITH LOW-DOSE KETAMINE ON AWAKE TRACHEAL INTUBATION IN PATIENTS WITH OSAS

Objective To observe the effect of dexmedetomidine combined with low-dose ketamine on awake tracheal intubation in patients with OSAS. Methods One hundred and twenty patients with OSAS undergoing UPPP under general anesthesia were evenly randomized to dexmedetomidine(group D),dexmedetomidine and ketamine(group C)and ketamine(group K).Ten minutes before intubation,the patients in group D were given dexmedetomidine(0.8μg/kg)through a venous pump completed in 10minutes;those in group C received dexmedetomidine same as done in group D,and plus 15 mg of ketamine;those in group K received ketamine(15mg)to be finished in 10 minutes through a venous pump.HR,MAP,SpO2,Ramsay score and bucking were recorded before anesthesia(T0),before intubation(T1)and at intubation(T2). Results At T2,the HR and MAP in group C were lower than groups D and K(F=13.33,6.37;q=4.37-6.32;P0.05);During intubation,the Ramsay score in group C was higher than groups D and K(F=30.05;q=9.85,9.09;P0.05),and the cases of bucking were much less(χ2=6.275,8.658;P0.05). Conclusion Injection of dexmedetomidine and low-dose ketamine before intubation can reduce the occurrence of bucking in patients with OSAS undergoing UPPP during awake intratracheal intubation,which makes the hemodynamics more stable and raises Ramsay score.