【摘 要】
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Objectives: Fiberoptic intubation is a valuable modality for airway management.This study compared remifentanil and dexmedetomidine as anesthetics for modified Awake Fiberoptic Intubation(AFOI).Method
【机 构】
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Department of anesthesiology,the First Affiliated Hospital of Guangzhou University of Chinese Medici
【出 处】
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中国中西医结合麻醉学会年会暨第二届全国中西医结合麻醉学术研讨会
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Objectives: Fiberoptic intubation is a valuable modality for airway management.This study compared remifentanil and dexmedetomidine as anesthetics for modified Awake Fiberoptic Intubation(AFOI).Methods: Sixty adult ASA Ⅰ-Ⅱ patients with anticipated difficult airways who were to undergo tracheal intubation for elective surgery,were enrolled in a double-blinded randomized pilot study to receive remifentanil(Rem)or dexmedetomidine(Dex)for sedation during modified AFOI.The Rem group(n=45)received a loading dose(0.75 μg/kg)of infused 0.15 μg/kg/min over 5 min,followed by a continuous infusion of 0.1mcg/kg/min.The Dex group(n=45)received a loading dose of 1 μg/kg infused over 10 min followed by an infusion of 0.3 μg/kg/h.Main outcomes were evaluated by grading scores representing conditions for intubation and post-intubation.Other parameters analyzed included: 1)airway obstruction;2)hemodynamic changes;3)time required for intubation;4)amnesia level;and 5)subjective satisfaction.Results: All ninety patients were successfully intubated by modified AFOI.The comfort scores and airway events during intubation were the same between two groups.The Rem group experienced less cough,and less time taken for tracheal intubation than the Dex group.However,the Dex group had less heart rate response to intubation than the Rem group.Conclusion: We are sure that modified AFOI is feasible and effective for difficult airway management,and that Dexemedetomidine and Remifentanil have similar efficacy as adjuvants to it.
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