Evaluation of retrograde intubation with different doses of dexmedetomidine infusion: A randomised controlled trial

Abstract

Background: Retrograde intubation is one of the well-described and alternative methods of difficult airway management. It requires effective sedation and patient preparation. Study was done to evaluate intubating conditions during retrograde guided intubation with two different doses of dexmedetomidine. Methods: This prospective randomized double blind parallel group trial was planned on 60 patients with difficult airway. Patients were divided in two groups to receive either dexmedetomidine 1.0 μg/kg (Group A) or dexmedetomidine 1.5 μg/kg (Group B) by intravenous (IV) route. The Modified Observer Assessment Awareness and Sedation (OAA/S) was measured as primary outcome and ease of intubation, facial grimace score, cough severity, hemodynamic response, patient recall and discomfort were assessed as secondary outcome during awake retrograde intubation. Results: Groups were comparable in terms of demographic and baseline parameters. OAA/S (P = 0.001), cough severity (P 0.05) between the two groups. Conclusion: Retrograde intubation can be easily learned and performed with minimal complications. Dexmedetomidine in a dose of 1.5 μg/kg IV is optimum and safe for retrograde intubation with clinically manageable side effects.

Keywords

• Airway management
• Awake intubation
• Conscious sedation
• Dexmedetomidine
• Nasal intubation
• Retrograde intubation