Abstract
Awake fibreoptic intubation (AFOI) is the gold standard technique for anticipated difficult airway management, requiring optimal sedation and airway anesthesia for successful outcomes. To compare the efficacy of dexmedetomidine with lignocaine versus plain lignocaine nebulization for achieving successful airway placement during awake fibreoptic intubation and to assess patient comfort, intubating conditions, hemodynamic stability, and intubation time. This observational cross-sectional study included 120 patients divided into two groups of 60 each. Group A received dexmedetomidine with lignocaine nebulization, while Group B received plain lignocaine nebulization. Various parameters including airway reflexes, hemodynamic variables, and intubation characteristics were assessed. Demographic and airway parameters were comparable between the groups (p>0.05). Group A demonstrated better hemodynamic stability with significantly lower SBP, DBP, MAP, and heart rate during intubation (p<0.05). First-attempt intubation success was higher in Group A (96.7%) compared to Group B (90.0%). Oxygen saturation remained stable in both groups. Complication rates were minimal and comparable. Dexmedetomidine combined with lignocaine nebulization provides superior intubating conditions, better patient comfort, and enhanced hemodynamic stability compared to plain lignocaine nebulization, making it a safe and effective technique for awake fibreoptic intubation.
Keywords: Dexmedetomidine; Lignocaine nebulization; Awake fibreoptic intubation; Hemodynamic stability