Fentanyl versus dexmedetomidine during awake-fibreoptic intubation

TL;DR

This study compares fentanyl and dexmedetomidine for managing heart rate and blood pressure during awake-fiberoptic intubation.

Contribution

It shows dexmedetomidine is more effective than fentanyl in managing heart rate during intubation.

Findings

Dexmedetomidine maintains lower systolic blood pressure compared to fentanyl.

Dexmedetomidine is more effective in reducing diastolic blood pressure.

Dexmedetomidine outperforms fentanyl in managing heart rate during and after intubation.

Abstract

Awake-fiberoptic intubation is considered the gold standard technique for managing an anticipated difficult airway. Therefore, it is
of interest to compare and evaluate fentanyl and dexmedetomidine on intubation conditions during awake-fiberoptic intubation. Hence, 90
patients were randomly divided into two groups, namely Group D and Group F, each consisting of 45 individuals. They were given
Dexmedetomidine (1 mcg/kg over 10 minutes) and fentanyl (2 mcg/kg over 10 minutes) followed by monitoring and recording using Ramsay
sedation scale at every 2 minutes, 5 minutes, 10 minutes and 20 minutes. Parameters like systolic blood pressure, diastolic blood
pressure and heart rate were noted. They found that, the differences are not statistically significant as time advances following
intubation, even though dexmedetomidine contributes to the maintenance of a lower systolic blood pressure. Further, the efficacy of
dexmedetomidine in reducing diastolic blood pressure is more pronounced; however, following intubation, the disparities between the two
groups diminish and it is not statistically significant. Thus, in comparison to fentanyl, dexmedetomidine demonstrates superior efficacy
in the management of heart rate both during and immediately following intubation.