ArticleJournal of anaesthesiology, clinical pharmacology
Dexmedetomidine vs. midazolam-ketamine for sedation during awake fiberoptic nasal intubation in patients with difficult airway - A randomized, double-blinded, comparative trial.
Article in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Efficacy and Safety of Remimazolam versus Dexmedetomidine and Midazolam in Awake Endotracheal Intubation for Difficult Airway Patients: A Randomized Controlled Study.Drug design, development and therapy · 2025Trial
- Hemodynamic Safety of Dexmedetomidine-Fentanyl Sedation During TAVI.Anatolian journal of cardiology · 2026Article
- Intranasal Dexmedetomidine on Post-operative Pain and Swelling after Third Molar Impaction Surgery - A Comparative Study.Annals of maxillofacial surgeryArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: Both dexmedetomidine and midazolam-ketamine are known for their minimal respiratory depressant effects. While many studies have documented the use of dexmedetomidine in providing conscious sedation during awake fiberoptic-guided nasal intubation (AFNI), the use of midazolam-ketamine combination for this procedure has not been reported. The aim of this study was to compare the efficacy of dexmedetomidine with midazolam-ketamine combination for AFNI in patients with difficult airways undergoing oromaxillofacial surgery. Material and Methods: This study involved 60 patients undergoing oromaxillofacial surgery. They were randomized to receive either dexmedetomidine (1 μg/kg) (group D) or a combination of midazolam (0.02 mg/kg) and ketamine (0.5 mg/kg) (group MK) for sedation during awake fiberoptic nasotracheal intubation. Both groups received topical local anesthesia during the procedure using the spray-as-you-go technique. The primary outcome measured was cough score during intubation. Secondary outcomes included overall intubation, post-intubation, and sedation scores. Incidences of side effects such as hypoxemia and bradycardia were also measured. Results: The cough score (group D: 1.33 ± 0.61, group MK: 1.3 ± 0.53; Conclusions: Both dexmedetomidine and midazolam-ketamine combinations were equally effective for sedation during AFNI in patients with difficult airways scheduled for orofacial maxillary surgery. Patients receiving dexmedetomidine were more sedated, but the incidence of side effects was similar in both groups.
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