Abstract No.: ABS0322: COMPARISON OF PROPOFOL AND DEXMEDETOMIDINE SEDATION FOR AWAKE C-MAC D-BLADE VIDEO-LARYNGOSCOPIC INTUBATION IN DIFFICULT AIRWAY CASES

BACKGROUND & AIMS: Safest method for securing difficult airway is awake intubation. Aim is to compare propofol and dexmedetomidine for C-MAC D-blade guided difficult intubation under conscious sedation. A prospective, interventional, two arm, randomised study including 60 American Society of Anesthesiologists (ASA )grade I-III patients. METHODS: After nasal packing, local anaesthesia, IV midazolam 0.03mg.kg-1and IV fentanyl 1µg.kg-1, in Group-P, propofol was infused at rate of 250 µg.kg.-1min-1, and in Group-D, dexmedetomidine 1 µg g.kg-1 over 10 min, then 0.5 µg .kg.-1h-1, till BIS values 65-70. Patients underwent C-MAC D-blade video-laryngosope guided intubation. Quantitative variables were compared using unpaired t-test/Mann-Whitney Test between groups and paired t-test/Wilcoxon ranked sum test across follow- up within the group. Qualitative variables were correlated using Chi-Square test/Fisher`s exact test. A p-value of <0.05 was considered statistically significant. Data was analysed by Statistical Package for Social Sciences (SPSS) version 24. RESULTS: The mean intubation score was higher in the dexmedetomidine group (4.4) [propofol group (3.6)]. Patient reaction to intubation and haemodynamic parameters were more favourable in the propofol group. Coughing and vocal cord movementwas comparable. Time to achieve desired BIS-value was 4 times longer and time to intubate was six seconds longer indexmedetomidine group. Percentage of Glottic Opening (POGO)scores were slightly better in the propofol group. Propofol group was comparatively complication free. CONCLUSION: Successful awake video-laryngoscopic intubation using the C-MAC D-blade can be performed in patients in both groups.Propofol gives a better intubation score and haemodynamic stability than dexmedetomidine.