THE STUDY TO EVALUATE THE SAFETY AND EFFICACY OF DEXMEDETOMIDINE DURING AWAKE FIBREOPTIC OROTRACHEAL INTUBATION IN PATIENTS SCHEDULED FOR CERVICAL SPINE SURGERIES: A PROSPECTIVE PLACEBO CONTROLLED DOUBLE BLINDED STUDY

Introduction: Fibreoptic intubation has become an integral part in management of anticipated difficult airways. Various anaesthetic drugs have been used to assist Awake fibreoptic intubation(AFOI) for producing conscious sedation to provide a calm ,cooperative and responsive patient without respiratory depression for successful awake fiberoptic intubation. Aims And Objective: The aim of the present study was to study the safety and efficacy of dexmedetomidine during awake fibreoptic orotracheal intubation in patients scheduled for cervical spine surgeries. Material And Methods: A randomized, prospective, placebo controlled comparative study design was conducted in sixty patients in JAH group of Hospitals. All patients were randomly divided into two groups : Group A (n=30) patients received dexmedetomidine (1μg/kg) in 0.9% 100 ml Normal Saline and Group B (n=30) patients received 0.9% 100 ml Normal Saline, each over 10 minutes as an intravenous infusion in a randomized blinded manner. The fibreoptic orotracheal intubation was performed and primary outcome was level of sedation assessed using Ramsay sedation score. Other parameters of study included cough score and intubation score to compare intubating conditions. The secondary outcomes of study included variations in hemodynamic parameters Heart Rate, SBP, DBP, MAP and SPO2 during drug infusion at 2 minutes interval, immediately after intubation and every 10 minutes after intubation till 30 minutes. Results: Dexmedetomidine had better sedation score, cough score and intubation score with stable hemodynamic variables than Group B(Normal Saline) with statistically significant results. Conclusion: Patients receiving dexmedetomidine had adequate and appropriate level of sedation providing more optimum conditions for AFOI with stable hemodynamic parameters and lesser adverse effects during the procedure.