Department of Anaesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Anaesthesia. 2010 Mar;65(3):254-9. doi: 10.1111/j.1365-2044.2009.06226.x. Epub 2010 Jan 22.
Fibreoptic intubation is a valuable modality for airway management. This study aimed to compare the effectiveness of dexmedetomidine vs target controlled propofol infusion in providing sedation during fibreoptic intubation. Forty patients with anticipated difficult airways and due to undergo tracheal intubation for elective surgery were enrolled and randomly allocated into the dexmedetomidine group (1.0 microg.kg(-1) over 10 min) (n = 20) or the propofol target controlled infusion group (n = 20). Intubating conditions and patient tolerance as graded by a scoring system were evaluated as primary outcomes. Intubation was successful in all patients. Satisfactory intubating conditions were found in both groups (19/20 in each group). The median (IOR [range]) comfort score was 2 (1-2 [1-4]) in the dexmedetomidine group and 3 (2-4 [2-5]) in the propofol group (p = 0.027), favouring the former. The dexmedetomidine group experienced fewer airway events and less heart rate response to intubation than the propofol group (p < 0.003 and p = 0.007, respectively). Both dexmedetomidine and propofol target-controlled infusion are effective for fibreoptic intubation. Dexmedetomidine allows better tolerance, more stable haemodynamic status and preserves a patent airway.
纤维光学插管是一种有价值的气道管理方式。本研究旨在比较右美托咪定与靶控输注丙泊酚在纤维光学插管中提供镇静效果。将 40 名预计有困难气道的患者，且因择期手术需要气管插管纳入研究，并随机分为右美托咪定组（1.0μg.kg(-1)，持续 10 分钟）（n = 20）或丙泊酚靶控输注组（n = 20）。插管条件和患者耐受性通过评分系统进行评估作为主要结局。所有患者插管均成功。两组均有满意的插管条件（每组 19/20）。右美托咪定组的中位数（IOR [范围]）舒适度评分为 2（1-2 [1-4]），丙泊酚组为 3（2-4 [2-5]）（p = 0.027），前者更优。与丙泊酚组相比，右美托咪定组的气道事件更少，心率对插管的反应更小（p < 0.003 和 p = 0.007）。右美托咪定和丙泊酚靶控输注均适用于纤维光学插管。右美托咪定可更好地耐受，更稳定的血流动力学状态并保持气道通畅。
