2025, Vol. 8, Issue 2, Part C

Aim: To compares the efficacy, safety, and impact of Dexmedetomidine and Fentanyl on hemodynamic and respiratory parameters during AFOI.

Materials and Methods: This prospective, randomized, endpoint-blinded study included 50 patients (ASA I/II, aged 20-50 years) undergoing elective surgery with anticipated difficult airways. Criteria included Mallampati Grade III/IV, restricted mouth opening, or thyromental distance <6.5 cm. Patients were randomly assigned into two groups: Group D received dexmedetomidine 1 mcg/kg and Group F received fentanyl 2 mcg/kg, both via slow infusion over 10 minutes. Sedation level was assessed using the Ramsay Sedation Score (RSS), intubation quality via cough and post-intubation scores, and hemodynamic parameters (HR, BP, SpO₂) were monitored intra-and post-operatively. Side effects such as bradycardia, hypotension, nausea, and hypoxia were also recorded.

Results: Dexmedetomidine provided superior intubation conditions with significantly lower cough scores (1.44±1.23 vs. 2.88±1.59, p<0.001), higher sedation (RSS 3.87±0.87 vs. 2.74±0.81, p<0.001), and better patient tolerance. Time to intubation and fiberoptic scope insertion was also shorter in Group D. Hemodynamic analysis revealed significantly lower HR and BP in Group D but at the cost of increased hypotension (24%) and bradycardia (32%). Group F, while more hemodynamically stable, had more hypoxia (24% vs. 4%) and nausea.