title: Efficacy of intravenous dexmedetomidine on patient's satisfaction, comfort and sedation during awake fibre-optic intubation in patients with cervical spondylotic myelopathy posted for elective cervical fixation.
abstract: OBJECTIVE
  Various anaesthetic drugs, in addition to airway block, are used for producing favourable intubation conditions during awake fibre-optic intubation (AFOI), but most of them cause respiratory depression and hypoxaemia. The aim of this study was to evaluate the efficacy of intravenous (IV) dexmedetomidine (DEX) on sedation, patient comfort and cardiovascular responses during AFOI in patients with cervical spondylotic myelopathy (CSM).
  
  
  METHODS
  This randomised, placebo-controlled, double-blinded, prospective study was conducted on 56 adult patients with cervical spondylotic myelopathy (CSM) undergoing elective cervical fixation, who were randomly allocated into two groups - Group D and Group C. Group D patients received DEX infusion at a rate of 1 μg/kg for the first 10 min followed by 0.5 μg/kg/h and Group C received 0.9% normal saline infusion in the same manner. Airway blocks with lignocaine were given to all patients before undergoing AFOI. Patient's alertness, sedation and cardiorespiratory changes during the procedure were assessed by the Observer Assessment Awareness and Sedation (OAA/S) scale. On the 1stpost-operative day, patient's' comfort during AFOI was assessed by visual analogue scale (VAS).
  
  
  RESULTS
  Patients of Group D had an acceptable level of sedation (OAA/S score: 20 to 17 with greater comfort and satisfaction (VAS: 40-60), compared to control group (VAS: 50-90,P< 0.001.). Moreover, haemodynamic parameters were less significantly altered in the DEX group during AFOI.
  
  
  CONCLUSIONS
  IV DEX infusion during AFOI improves patient's tolerances with an acceptable level of sedation without significant haemodynamic instability and respiratory depression.
authors.affiliation: Department of Anesthesia, Bangur Institute of Neurosciences, Kolkata, West Bengal, India.
authors.forename: Saikat
authors.initials: S
authors.lastname: Niyogi
authors.affiliation: Department of Anaesthesia, Central Hospital, Kolkata, West Bengal, India.
authors.forename: Samir
authors.initials: S
authors.lastname: Basak
authors.affiliation: Department of Anesthesia, Bangur Institute of Neurosciences, Kolkata, West Bengal, India.
authors.forename: Amita
authors.initials: A
authors.lastname: Acharjee
authors.affiliation: Department of Anesthesia, Bangur Institute of Neurosciences, Kolkata, West Bengal, India.
authors.forename: Indrani
authors.initials: I
authors.lastname: Chakraborty
keywords: Airway block; awake fibre-optic intubation; intravenous dexmedetomidine