Effect of Intravenous versus Nebulised Dexmedetomidine on Intubating Conditions during Awake Fiberoptic Intubation: A Prospective Randomised Double Blind Comparative Study

Background and Aims: Awake fibreoptic intubation (AFOI) tend to be safer than conventional laryngoscopy for difficult airway conditions. Dexmedetomidine can be used for sedation as it ensures spontaneous breathing with airway patency. We aim to assess the effect of intravenous versus nebulized dexmedetomidine on intubating conditions during AFOI. Methods: In this prospective randomized double blind comparative study, after IEC approval, CTRI registration and informed written consent, ASA grade I, II patients of either gender aged 18-60 year with Mallampati grade I, II undergoing elective surgery under general anaesthesia were allocated into two groups –Group N and I to receive dexmedetomidine 1mcg/kg via nebulization and intravenous route respectively. Patients were intubated with fibreoptic bronchoscope. The primary outcome assessed was cough score. Secondary outcomes were- time taken for AFOI, intubating conditions, vocal cord position, post intubation score, Ramsay sedation scale, haemodynamic parameters, patient comfort, cooperativeness and satisfaction. Data were analysed using SPSS version 25. Continuous, ordinal and categorical data were presented as mean±SD, median±IQR and proportion respectively. Student-t test, Mann Whitney U test and Chi-square test were applied where deemed appropriate. p