The AFOI with Intravenous Dexmedetomidine as an Airway Management Technique of Choice in Planned Maxillofacial/ Panfacial Injury Reconstruction Surgeries – A Case Series

Maxillofacial trauma poses significant airway management challenges for anesthesiologists due to the risk of difficulty in ventilation and difficulty in intubation. Effective airway management is critical during elective surgeries, as both the anesthesiologist and surgeon require adequate space for their respective tasks, particularly when maxillomandibular fixation is necessary for reconstructing facial fractures. Awake fiber-optic intubation(AFOI) is most preferred in the anticipated difficult airway management. Adequate sedation with effective airway topical anesthesia is of para‐ mount to achieve that as well as to improve intolerance, alleviate discomfort, and achieve successful AFOI. Dexmedetomidine is a preferred sedative due to its effectiveness without significant respiratory depression, providing better tolerability in AFOI compared to other agents. AFOI with dexmeditomide sedation also enhances patient comfort ,provides good hemodynamic stability , better intubating conditions and significantly improves clinical outcomes. We have presented AFOI with Dexmedetomidine sedation as the most appropriate approach in a series of cases with anticipated difficult airway due to panfacial/maxillofacial trauma undergoing elective facial bone reconstructive surgeries.