Comparison of Dexmedetomidine and Fentanyl for awake intubation in neonates

Abstract

The aim of this study is to comparison of Dexmedetomidine and Fentanyl for awake intubation in neonates. Materials and Methods: This was a clinical trial study and the target population included term and preterm neonates, required awake intubation at the Tabriz Children's Educational and Medical Center in 2018-19. After obtaining informed consent from the parents of all patients and the approval of the Ethics Committee of Tabriz University of Medical Sciences, 70 neonates with ASA class 1 to 3 of the surgical candidate who were divided into two groups of 35 entered the study. The neonates were randomly divided into two groups, Fentanyl and Dexmedetomidine and then, pre-meditation was performed in group F with 2µg/kg of Normal saline and in group D with 1µg/kg of Dexmedetomidine. 3 minutes after pre-meditation, the Sedation score was assessed. Then laryngoscopy was performed with a suitable Miller blade and the patient was intubated with an endotracheal tube of appropriate size by an experienced anesthesiologist. The number of attempts and time required for successful intubation was recorded in each group. In both groups, the patient's vital signs, including HR, SBP, DBP, MAP, and SPO2, were recorded from the beginning of the study to 5 minutes after the intubation. Results: In this study Of all the variables related to the frequency and time required for successful intubation and side effects, only the variables of the apnea episode (P-value = 0.011) and the duration of apnea (P-value = 0.005) were different statistically in the two groups of neonates studied that in the Fentanyl group was more than the Dexmedetomidine group, and other variables such as: sedation score, number of intubation attempts, intubation time, airway trauma, and side effects did not show statistically difference in the two groups of neonates studied (P-value> 0.05). Regarding the results of HR, SBP, DBP, MAP and blood oxygen saturation levels from the beginning of the study to 5 minutes after intubation, except for heart rate values within 4 minutes (P-value = 0.048) and 5 minutes (P-value = 0.032) after intubation, which was higher in the Fentanyl group than in the Dexmedetomidine group, the difference in the values of these factors between the two groups of Dexmedetomidine and Fentanyl was is insignificant at all time intervals (P-value> 0.05).