Efficacy of Adding Low-Dose Ketamine to Dexmedetomidine Versus Low-Dose Ketamine and Propofol for Conscious Sedation in Patients Undergoing Awake Fiber-optic Intubation

BACKGROUND AND AIMS: Conscious sedation is the key for successful AFOI. This trial was conducted to compare the effectiveness of dexmedetomidine and low dose of ketamine against propofol and low dose ketamine. MATERIALS AND METHODS: Sixty patients subjected for general anesthesia were invited to participate in the study and randomly allocated into two equal groups: D-K (n = 30) had been received a bolus dose of both ketamine 0.5mg /kg and dexmedetomidine 1ug/kg over 10 min. Then continuous infusion of ketamine 0.5mg /kg and dexmedetomidine 1ug/kg. The second group (P-K group) (n = 30): had been received a bolus dose of both ketamine 0.5mg/kg and propofol 1mg/kg over 10 min. Then continuous infusion of ketamine 0. 5mg/kg and propofol 1mg/kg. RESULTS: The intubation time was statistically significant shorter within the D-K group (58.9 ± 6.1) versus P-K group (63.4 ± 5.3) with p-value 0.02. The shorter time needed to achieve the OAA/S score = 2 was in the D-K group (2.25 ± 0.75) versus (2.9 ± 0.79) in P-K group with (P-value 0.004). The intubation scores were insignificant different between both groups except vocal cord opening which was statistical better among D-K group with P-value 0.03. The significant hypotensive recorded data were among P-K group while the decreased heart rate were recorded in D-K group. Eighty percentages of patients had excellent score of satisfaction within the D-K gp against 47% among the patients within P-K gp with P-value 0.01. CONCLUSION: The concomitant administration of low dose of ketamine with dexmedetomidine had better intubation time and sedation scores with higher patient satisfaction scores than the combination of propofol and low dose of ketamine.