Comparative study of midazolam and nalbuphine with midazolam and fentanyl for analgesic and sedative effect in patients undergoing awake fibre-optic intubation- Original research
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 922-927
AbstractAim: The purpose of the present study was to assess the comparison between midazolam-nalbuphine and midazolam-fentanyl combinations for analgesic as well as sedative effect in patients who have undergone fibre-optic intubation in awake state.
Methodology: 100 patients between the age of 20 and 60 yrs of either sex, scheduled for elective surgery were included after taking written informed consent. Premedication with Inj. Glycopyrrolate 0.2 mg i.m. 30 mins before and Inj. Midazolam 1 mg i.v. 15 mins before the procedure was given. Then patients were randomly divided into 2 groups. Group N (n=30) received inj. nalbuphine 0.2 mg/kg i.v. and group B (n=30) received inj. fentanyl 2 mcg/kg i.v., both 5 mins prior to the introduction of fiberscope. The nasotracheal fiberoptic intubation was carried out using spray as you go technique. Level of sedation, intubation score and VAS score were observed along with patient comfort score
Results: Group F patients had better sedation score (P=0.328), VAS score (P=0.184), significantly better intubation score (P=0.00), intubation time (0.00) and patient comfort score (P=0.05). Hemodynamics (heart rate, systolic blood pressure, diastolic blood pressure) were significantly better in group F.
Conclusion: Fentanyl-midazolam combination for awake fibreoptic intubation using spray as you go technique, provided better sedation and analgesia, obtunded airway reflexes and minimized pressor response to awake fibreoptic intubation and provided better patient comfort.
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