Comparison of Two Different Doses of Intravenous Dexmedetomidine with Ketamine on Intubation Response and Patient Satisfaction in Awake Fiberoptic Nasotracheal Intubation: A Prospective Randomized Clinical Study (Code-T0252)

Introduction: Awake fiberoptic intubation (AFOI) is a critical technique for securing the airway in patients with anticipated difficult intubation. Dexmedetomidine, a selective α2-adrenoceptor agonist, provides sedation and analgesia while maintaining respiratory function, making it an ideal agent for AFOI. Ketamine, an NMDA receptor antagonist, enhances sedation and hemodynamic stability. This study aims to compare the efficacy of two different doses of intravenous dexmedetomidine in combination with ketamine for optimizing intubation conditions and patient satisfaction during AFOI.

Aims and Objectives:

1. To assess intubation conditions and patient satisfaction during awake fiberoptic nasotracheal intubation.
2. To compare the hemodynamic response to different doses of dexmedetomidine combined with ketamine.
3. To evaluate potential adverse effects associated with the study drugs.

Methods: This prospective, randomized clinical study will be conducted at G.R. Medical College, Gwalior, over a period of 14 months. A total of 102 patients undergoing elective surgery requiring nasotracheal intubation will be randomized into two groups. Group D1K will receive dexmedetomidine (1 µg/kg) with ketamine (15 mg), while Group D2K will receive dexmedetomidine (0.75 µg/kg) with ketamine (15 mg). Intubation conditions, sedation levels, hemodynamic parameters, and patient satisfaction will be assessed. Statistical analysis will be performed using SPSS software.

Results: The study will determine which dexmedetomidine dose, when combined with ketamine, provides optimal intubation conditions, better hemodynamic stability, and higher patient satisfaction.

Conclusion: This study will help identify an optimal sedation strategy for awake fiberoptic intubation, potentially improving patient outcomes and procedural safety.

Keywords: Awake Fiberoptic Intubation, Dexmedetomidine, Ketamine, Hemodynamic Stability, Patient Satisfaction, Airway Management.