scholarly journals Dexmedetomidine in the Management of Awake Fiberoptic Intubation

2019 ◽  
Vol 13 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Aniello Alfieri ◽  
Maria B. Passavanti ◽  
Sveva Di Franco ◽  
Pasquale Sansone ◽  
Paola Vosa ◽  
...  
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Practice Guidelines ◽  
Gold Standard ◽  
Fibreoptic Intubation ◽  
Patient Comfort ◽  
Fiberoptic Intubation ◽  
Difficult Airway Management ◽  
Patient Discomfort ◽  
Awake Fiberoptic Intubation

Awake Fibreoptic Intubation (AFOI) is, nowadays, the gold standard in predicted difficult airway management. Numerous practice guidelines have been developed to assist clinicians facing with a difficult airway. If conducted without sedation, it is common that this procedure may lead to high patient discomfort and severe hemodynamic responses. Sedation is frequently used to make the process more tolerable to patients even if it is not always easy to strike a balance between patient comfort, safety, co-operation, and good intubating conditions. In the last years, many drugs and drug combinations have been described. This minireview aims to discuss the evidence supporting the use of Dexmedetomidine (DEX) in the AFOI management.

scholarly journals A PROSPECTIVE RANDOMIZED STUDY TO EVALUATE THE ANALGESIC AND SEDATIVE EFFECTS OF FENTANYL AND MIDAZOLAM TO NALBUPHINE AND MIDAZOLAM IN PATIENTS UNDERGOING AWAKE FIBEROPTIC

2021 ◽  
Vol 9 (09) ◽  
pp. 530-538
Author(s):  
Akshat Taneja ◽  
◽  
Akash Gupta ◽  
Malti Agrawal ◽  
Upasana Asooja ◽  
...  
Keyword(s):  
Difficult Airway ◽  
Pressor Response ◽  
Randomized Study ◽  
Patient Comfort ◽  
Fiberoptic Intubation ◽  
Intubation Attempt ◽  
Intubation Time ◽  
Intubating Conditions ◽  
Sedative Effects ◽  
Awake Fiberoptic Intubation

Background- Awake nasal or oral flexible fiberoptic intubation (AFOI) is technique of choice in known or anticipated difficult airway . The main aim was to have calm and cooperative patient who can follow verbal commands while maintaining adequate oxygenation . In our study, we compared the analgesic and sedative effects of fentanyl and midazolam with nalbuphine and midazolam in patients undergoing awake fiberoptic intubationmore tolerable and comfortable for the patient but also to ensure optimal intubating conditions. Material and Methods– A prospective, randomized comparison study among patients between the age of 18 and 60yrs of either sex, with anticipated difficult airway . We compared the analgesic and sedative effects of fentanyl and midazolam with nalbuphine and midazolam in patients undergoing awake fiberoptic intubation. The primary objectives of our study were to observe the level of sedation, intubation score and OAS score after completion of procedure. The secondary objectives included assessment of patient comfort, intubation time, hemodynamic changes and complications. Results – We found that comfort score and intubation time were significant lesser in Group which received fentanyl and midazolam than Group which received nalbuphine and midazolam . (p<0.05). The intubation attempt was similar in both groups (P>0.05). Conclusion– we concluded that both regimens used in this study provided comparable intubating conditions, better sedation and analgesia was observed in group fentanyl for airway procedure events. Our study concluded fentanyl to be the drug of choice for blunting of pressor response in such patients.

scholarly journals Manejo anestésico de resección de quiste de vallécula en neonato. A propósito de un caso

2020 ◽  
Vol 49 (4) ◽  
pp. 576-580
Author(s):  
Neus Fuertes S. ◽  
José Cortell B. ◽  
Juan Camilo Jaramillo G. ◽  
Pilar Argente N.
Keyword(s):  
Airway Management ◽  
Respiratory Distress ◽  
Difficult Airway ◽  
Gold Standard ◽  
Orotracheal Intubation ◽  
Spontaneous Ventilation ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Difficult Airway Management ◽  
Alternative Management

Difficult airway management is one of the most important challenges an anesthesiologist faces. It is due to the high morbidity and mortality that it entails. The challenge is even greater if the patient is a newborn. For this reason, we should have different strategies that allow us to anticipate and treat possible complications derived from the procedure. In this case, we present a newborn with vallecular cyst and respiratory distress who is admitted for cyst resection. The gold-standard in anticipated difficult airway management is the fibrobronchoscope. We decided to perform an alternative management by means of orotracheal intubation with videolaryngoscope (Glydescope) in spontaneous ventilation.

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