Comparison of Dexmedetomidine and Midazolam for sedation in elderly patients with upper cervical spine fracture in awake tracheal intubation

Objective To compare the effects of Dexmedetomidine and Midazolam for sedation in elderly patient with upper cervical spine fracture in awake tracheal intubation. Methods A total of 68 patients with upper cervical spine fracture undergoing awake tracheal intubation who treated in our hospital from Jan. 2010 to Jan. 2015 were considered as the objects, who was randomly divided into group A and group B. 34 cases in group A were treated with Dexmedetomidine for sedation, and the other 34 cases in group B were treated with Midazolam for sedation. The Heart rate (HR), mean arterial pressure (MAP) and BIS value on the before anesthesia (T1), immediately before intubation (T2), immediately after intubation (T3), PaCO2 in before and after intubation, and the adverse reactions were compared between the two groups. Results There was no difference in HR, MAP and BIS at time of T1 between the two groups (P>0.05). The HR, MAP and BIS were lower in group A than in group B at time of T2 and T3 (P 0.05). The rate of adverse effects had no difference between the two groups (χ2=1.308, P=0.253). Conclusions Compared with Midazolam, Dexmedetomidine can stable HR, MAP and BIS effectively and has a good safety in the treatment of elderly upper cervical spine fracture in awake tracheal intubation, which is worthy of clinical application. Key words: Dexmedetomidine; Midazolam; Cervical vertebrae; Fractures; Intubation, intratracheal