Purpose: To evaluate the sedative effect of dexmedetomidine in awake intubation and its influence on swallowing function.
Methods: Fifty patients with awake intubation in oral and maxillofacial surgery were randomly divided into two groups: dexmedetomidine(DEX) group and midazolam+fentanyl(MF) group. 15 min before intubation, patients in DEX group were intravenously given 50 mL dexmedetomidine(1.0 μg/kg), and others in MF group were intravenously given 50 mL normal saline respectively. 5 min before intubation, 10 mL normal saline was given to DEX group, 0.02 mg/kg midazolam and 2.0 μg/kg fentanyl were given to MF group. HR, MAP, RR, SpO2, Ramsay sedation score and swallowing time were measured at different time points (before induction-T0, before intubation-T1 and after intubation-T2). SPSS 20.0 software package was used for data analysis.
Results: There was no significant difference in HR, RR, MAP, SpO2 and swallowing time between the two groups at T0 time point(P>0.05). Compared with MF group, HR significantly decreased and swallowing time significantly shortened(P<0.05). RR, MAP, SpO2 and Ramsay sedation score had no significant difference (P>0.05) in DEX group at T1 time point. Compared with MF group, HR significantly decreased and Ramsay sedation score significantly increased(P<0.05); RR, MAP and SpO2 had no significant difference (P>0.05) in DEX group at T2 time point. Compared with T0 time, HR significantly decreased and swallowing time significantly prolonged (P<0.05); RR, MAP and SpO2 had no significant difference(P>0.05) in DEX group at T1 time point. Compared with T1 time, Ramsay sedation score decreased with significant difference(P<0.05) at T2 time point.
Conclusions: Dexmedetomidine can provide good sedative effect for patients with awaking intubation without obvious inhibitory effect on swallowing reflex of patients, improving the safety of intubation.