Sedation Effect Of Dexmetomidine Combined With Fentanyl In Conscious Nasal Tracheal Intubation

Objective:It is the aim to evaluate sedation effect of dexmetomidine combined with fentanyl in conscious nasal tracheal intubation.Methods:One hundred and twenty ASA I or II patients scheduled to receive general anesthesia were randomly divided into 3 groups?n=40?.Group L received an infusion of 1?g/kg dexmedetomidine;Group H received an infusion of 2?g/kg dexmedetomidine;Group DF received an infusion of 1?g/kg dexmedetomidine added to 1?g/kg fentanyl.Nasotracheal intubation was performed after complete topical anesthesia.HR,SpO₂ and MAP were recorded before anesthesia?baseline,T₀?,before intubation?T₁?,immediately after intubation?T₂?.All patients were assessed for:the intubation score?vocal cord movement,coughing and limb movement?,fiberoptic intubation score,nasotracheal intubation score and airway obstraction score.On the first post-operative day,adverse events and satisfaction score were also assessed.Results::HR and MAP at T₁ in three groups were significantly lower than those at T₀?P<0.05?.HR and MAP at T₂ in group L were significantly higher than those in group H and DF?P<0.05?.The coefficient of variation for HR or MAP did not differ between group H and Group DF.Group L showed more incidence of vocal cord closed,severe cough,severe limb movement,heavy grimacing,defensive movement of head and hands after nasotracheal intubation than the other two groups?P<0.05?.The incidence of airway obstraction and bradycardia in group H were higher than those in group L and DF?P<0.05?.There was no statistical difference in the postoperative adverse reactions between the three groups.But the overall satisfaction score of group H and DF were higer?P<0.05?.Conclusion:Adding 1?g/kg fentanyl to 1?g/kg dexmedetomidine is a good method for awake nasotracheal fiberoptic intubation which can prevent the risk of airway obstruction associated with increasing the dose of dexmedetomidine while achieving the same favorable sedation.