title: Comparison of dexmedetomidine and sufentanil for conscious sedation in patients undergoing awake fibreoptic nasotracheal intubation: a prospective, randomised and controlled clinical trial.
abstract: BACKGROUND
  Fibreoptic intubation is a valuable technique for difficult airway management in which conscious sedation is paramount.
  
  
  OBJECTIVE
  To investigate the efficacy and safety of dexmedetomidine (DEX) and sufentanil (SUF) for conscious sedation during awake nasotracheal intubation under vision by a fibreoptic bronchoscope.
  
  
  METHODS
  Forty patients with anticipated difficult airways of American Society of Anesthesiologists I-II scheduled for awake fibreoptic nasotracheal intubation were randomised into two groups each containing 20 subjects. DEX group received DEX at a dose of 1.0 μg/kg over 10 min followed by a continuous infusion of 0.5 μg/kg per hour, while SUF group received SUF target controlled infusion in which the target plasma concentration was 0.3 ng/mL. The nasotracheal intubation conditions and the tolerance to nasotracheal intubation were observed; the occurrence of adverse events including hypertension, bradycardia and respiratory depression during nasotracheal intubation and post-surgical throat pain and hoarseness, and post-surgical memory score were recorded.
  
  
  RESULTS
  Better nasotracheal intubation conditions and higher tolerance to intubation were observed in DEX group than those in SUF group (P < 0.05). The incidence rates of hypertension, respiratory depression during intubation and throat pain after surgery were lower in DEX group than those in SUF group; however, the incidence of bradycardia was higher in DEX group than that in SUF group.
  
  
  CONCLUSIONS
  DEX provides better nasotracheal intubation conditions, improves patients' tolerance to intubation and leads to lower occurrence of hypertension, respiratory depression and throat pain and post-surgical memory score for sedation during awake fibreoptic nasotracheal intubation.
authors.affiliation: Department of Anesthesiology, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: She-Liang
authors.initials: SL
authors.lastname: Shen
authors.forename: Yi-hong
authors.initials: YH
authors.lastname: Xie
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Wang
authors.forename: Shuang-Fei
authors.initials: SF
authors.lastname: Hu
authors.forename: Yun-Long
authors.initials: YL
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D016292:Procedural Sedation / Q000379:methods; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D005336:Fiber Optic Technology; D017052:Hospital Mortality; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007442:Intubation, Intratracheal / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D017409:Sufentanil / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D017409:Sufentanil
keywords: awake nasotracheal intubation; dexmedetomidine; fibreoptic bronchoscope; sedation; sufentanil