A COMPARATIVE EVALUATION OF EFFICACY OF NEBULIZATION WITH DEXMEDETOMIDINE AND 4% LIGNOCAINE PLUS DEXMEDETOMIDINE FOR AWAKE FIBREOPTIC INTUBATION (AFOI) IN DIFFICULT AIRWAY SCENARIO: A RANDOMIZED CONTROL TRIAL

Abstract: Background and Objectives: For expected difficult intubation, awake fiberoptic intubation (AFOI) is regarded as the gold standard. The purpose of this study was to evaluate the effectiveness of nebulization using two distinct medications, namely lignocaine and dexmedetomidine alone. Materials and Procedures: This was a double-blind, prospective, randomized study. Two equal groups of forty patients each were created: Group D received nebulization before undergoing AFOI with 2 mcg/kg of dexmedetomidine and distilled water (10 ml total), and Group LD received nebulization with 2 mcg/kg of dexmedetomidine and 5 mcg/kg of 4% lignocaine (10 ml total). Patients were ASA grade I and II, aged 20 to 60, and expected difficult intubation (LEMON>2). Patients were given 0.5 mg/kg of propofol and 2 mcg/kg of fentanyl. The OAA score, or observer rating of alertness, was one of the parameters recorded. Hemodynamic alterations were expressed as mean ± SD, rescue doses of propofol, cough severity score, vocal cord movement, limb movement, and fibreoptic intubation score. Conclusion: Compared to nebulization with 2 mcg/kg of dexmedetomidine alone, nebulization with 4% lignocaine and 2 mcg/kg of dexmedetomidine before undergoing AFOI produced a higher grade of anaesthesia.