RESUMO
Background: Providing adequate anxiolysis and sedation with a patent airway while performing fiberoptic bronchoscopic intubation is a challenging task to an anaesthetist. Ideal sedation would ensure calm and cooperative patient maintaining spontaneous ventilation. Dexmedetomidine is such a α2a adrenergic agonist with sympatholytic, analgesic, and sedative properties. Though its role is very well documented for sedation, proving it better than propofol for the procedure is being considered in this study. Methods: In total of 60 patients, after nebulizing with 5 ml of 4% lignocaine over 10 minutes, 30 patients were infused with dexmedetomidine @1μg/kg over 10 minutes followed by 0.3μg/kg and rest with propofol @1mg/kg. Fiber-optic bronchoscopy was done after 10 minutes of infusion. Monitoring was done considering heart rate, blood pressure, Ramsay sedation score and patient tolerance. Results: had shown successful intubation in both cases but dexmedetomidine had a better outcome with respect to sympathetic response and patient tolerance. P value was significant for sedation score, pre and post bronchoscopic intubation sympathetic response. No episodes of airway obstruction and hypoxia were noted with dexmedetomidine as compared with propofol. Mean Ramsay sedation score was 3.77 as compared to 2.33 with propofol. Conclusion: In our comparative study, Dexmedetomidine had offered better patient tolerance with adequate sedation and preservation of airway as compared to propofol and a reduced hemodynamic response to intubation.