The use of dexmedetomidine in fibrooptic tracheal intubation in patients with predictable difficult respiratory tract during head and neck surgical interventions

Abstract

The study included 31 oncological patients who underwent surgical treatment for head and neck tumors. Airway patency was assured by fibrooptic intubation of the trachea while preserving the patient's spontaneous breathing. 15-20 min before the fibrooptic tracheal intubation, dexmedetomidine was administered intravenously at the dose of 3 μg/kg per 1 h until the loading dose of 1 μg/kg was reached. Fibrooptic intubation of the trachea had been applied till the patient's sedation exceeded 3 scores on the Ramsay sedation scale. In all observations, patients maintained spontaneous breathing. Immediately prior to the introduction of the fibrobronchoscope, lidocaine in the dose of 1.5 mg/kg and ketamine (0.5 mg/kg) were administered intravenously. Further, fibrooptic tracheal intubation was carried out, the quality of which was evaluated by the anesthesiologist directly while it was performed and by the patient in the postoperative period.

Keywords

• dexmedetomidine
• neck and head cancer
• fibreoptic tracheal intubation
• ketamine
• lidocaine