Effects of dexmedetomidine on reactions of awake blind nasal intubation in elderly patients undergoing maxillofacial surgery

Objective To investigate the effects of dexmedetomidine on reactions of awake blind nasal intubation in elderly patients undergoing maxillofacial surgery. Methods Sixty-four elderly patients undergoing elective oral and maxillofacial surgery were randomly divided into dexmedetomidine group (n=32) and midazolam group (n=32). Ten min before intubation, the patients in dexmedetomidine group were given 0.8 μg/kg loading dose of dexmedetomidine infusion, which was completed within 10 min, followed by 0.5 μg/(kg·h) sustain. The patients in midazolam group were given 0.04 mg/kg midazolam composite 1 μg/kg fentanyl, which were intravenous administration at one-time. The levels of RR, HR, MAP, SpO2 and Ramsay sedation scores of patients in the two groups at different time points were recorded. The number of intubation attempts, intubation success rate, intubation times and complications during the first intubated in the two groups were recorded. Results The intubation success rate of dexmedetomidine group was 96.9%, which was higher than that (81.3%) of the midazolam group (P 0.05). Compared with midazolam group, the levels of RR, HR and MAP in dexmedetomidine group at T2-4 were all lower than those of the midazolam group (P<0.05), SpO2 and Ramsay scores at T1-4 were all higher than those of the midazolam group (P<0.05). The during intubation and postoperative complication rate in dexmedetomidine group during and after intubation was 12.5% and 9.4%, respectively, which were significantly lower than those of the midazolam group (P<0.05). The proportion of class Ⅰanesthesia induction effect in dexmedetomidine group was significantly higher than that in midazolam group (P<0.05). Conclusions Dexmedetomidine used in elderly patients undergoing maxillofacial surgery during awake blind nasal intubation can contribute to providing appropriate depth of anesthesia, and reduce the impact on the cardiovascular response. Key words: Elderly; Maxillofacial surgery; Dexmedetomidine; Awake blind nasal intubation; Cardiovascular response