Aim: The present study aimed to compare intubation conditions and the incidence of desaturation between the dexmedetomidine and fentanyl groups during awake fiberopticbronchoscopic intubation (AFOI). Material & methods: This randomized double-blind prospective study was conducted on a total of 100 patients scheduled for elective laparotomies who were randomly allocated into two groups: Group A (n=50)received dexmedetomidine 1 mcg/kg and Group B (n=50) received fentanyl 2 mcg/kg over 10 min. Patients in both groups received glycopyrrolate 0.2 mg intravenous, nebulization with 2% lidocaine 4 ml over 20 min and 10% lidocaine spray before undergoing AFOI. Adequacy of intubation condition was evaluated by cough score and post-intubation score. Incidence of desaturation, hemodynamic changes and sedation using Ramsay sedation scale (RSS) were noted and compared between two groups. Results: The various demographic parameters like mean age, sex, weight distribution and ASA physical status were comparable in two groups. When the two groups were compared with respect to cough score, in Group A, the number of patients with a Ramsay sedation scale (RSS) was significantly more as compared to Group B. In Group A, the mean HR just after intubation was 77.20 ± 11.12 bpm which was less than mean baseline HR but was statistically insignificant, (P = 0.9748) while in Group B, the mean HR just after intubation was 80.67 ± 11.78 bpm which was more than mean baseline HR which was statistically significant but clinically acceptable.(P = 0.010). Similarly In Group A, the mean MAP just after intubation was 92.83 ± 12.20 which was more than mean baseline MAP. (P = 0.715) and in Group B, the mean MAP just after intubation was 95.97 ± 11.23 which was significantly more than the mean baseline MAP. (P = 0.0052) but both HR and MAP were found to be in clinically acceptable range in two groups. Conclusion: Dexmedetomidine is more effective than fentanyl in producing better intubation conditions, sedation along with hemodynamic stability and less desaturation during AFOI.

Awake Fiberoptic Intubation, Conscious Sedation, Dexmedetomidine, Intubating Conditions, Fentanyl, Oxygen Desaturation