Journal article
Awake intubation under sedation using target-controlled infusion of dexmedetomidine: five case reports
Journal of anesthesia, Vol.24(5), pp.789-792
10/2010
DOI: 10.1007/s00540-010-0980-8
PMID: 20607313
Abstract
We used target-controlled infusion (TCI) of dexmedetomidine (DEX) for awake intubation under sedation in 5 patients who had a risk of pulmonary aspiration or difficult airway. Dexmedetomidine level was escalated stepwise until the patients developed tolerance to laryngoscopy. The target DEX concentrations at the time of intubation were 2.10–5.95 ng/ml and were higher than those clinically used for sedation in the intensive care unit (ICU). Chin lift was applied in 1 case, and therefore no assisted ventilation was required and pulse oxygen saturation was maintained at >98% throughout the procedure. Simple pharmacological interventions for blood pressure changes induced by increased target plasma DEX concentrations were needed in 4 cases. However, hemodynamics was stable, and no cardiovascular drug was needed after tracheal intubation. Conditions at laryngoscopy were excellent in all cases, and conditions at tracheal intubation were good except in 1 case. Reflex to intubation was preserved in all cases, and coughing was observed in all cases. The patients had no memory of discomfort and/or intubation. Although further investigations are needed, this method may be useful for awake intubation under sedation.
Details
- Title: Subtitle
- Awake intubation under sedation using target-controlled infusion of dexmedetomidine: five case reports
- Creators
- Takayuki Kunisawa - Department of Anesthesiology and Critical Care Medicine Asahikawa Medical College 2-1-1-1 Midorigaoka-higashi Asahikawa Hokkaido 0788510 JapanMichio Nagashima - Department of Anesthesiology and Critical Care Medicine Asahikawa Medical College 2-1-1-1 Midorigaoka-higashi Asahikawa Hokkaido 0788510 JapanSatoshi Hanada - Department of Anesthesiology Maimonides Medical Center 4802 Tenth Avenue Brooklyn NY 11219 USAAkihiro Suzuki - Department of Anesthesiology and Critical Care Medicine Asahikawa Medical College 2-1-1-1 Midorigaoka-higashi Asahikawa Hokkaido 0788510 JapanOsamu Takahata - Department of Anesthesiology and Critical Care Medicine Asahikawa Medical College 2-1-1-1 Midorigaoka-higashi Asahikawa Hokkaido 0788510 JapanHiroshi Iwasaki - Department of Anesthesiology and Critical Care Medicine Asahikawa Medical College 2-1-1-1 Midorigaoka-higashi Asahikawa Hokkaido 0788510 Japan
- Resource Type
- Journal article
- Publication Details
- Journal of anesthesia, Vol.24(5), pp.789-792
- Publisher
- Springer Japan; Japan
- DOI
- 10.1007/s00540-010-0980-8
- PMID
- 20607313
- ISSN
- 0913-8668
- eISSN
- 1438-8359
- Language
- English
- Date published
- 10/2010
- Academic Unit
- Anesthesia
- Record Identifier
- 9984007164802771
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