The Feasibility of Endotracheal Intubation with Subcutaneous Dissociative Conscious Sedation versus General Anesthesia: A Prospective Randomized TrialReport as inadecuate




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Despite outstanding improvements in anesthesia techniques and anesthetics, difficult airway is still a dilemma and is accompanied by morbidity and mortality. The aim of this study is to compare the feasibility of endotracheal intubation with the traditionalmethod of general anesthesia by using muscle relaxants, and -sDCS- SubcutaneousDissociative Conscious Sedation which has been recently reported as anefficient method of anesthesia with the capability of maintainingspontaneous ventilation and providing an appropriate situation forlarynxgoscopy and endotracheal intubation. Material and Methods: This randomizedclinical trial was conducted on 100 patients who were scheduled for elective laparotomy. Patients wererandomly divided into two groups: group A and group B. In group A, patientsunderwent general anesthesia with thiopental sodium and relaxant. In group B, patientsunderwent -subcutaneous Dissociative Conscious Sedation- and received low dosesubcutaneous ketamine and intravenous narcotic with no relaxant. The feasibility of direct laryngoscopyand tracheal intubation, hemodynamic changes, desaturation SpO2 < 90%, patientcooperation, patient comfort, hallucination, nausea and vomiting, nystagmus and salivation were evaluated in two groups. Adverse events including apnea and need forpositive pressure mask ventilation, additional dose offentanyl were recorded in group B. The anesthesiologist who performed theprocedure was asked about the patient calmness and cooperation during theprocedure and the feasibility of laryngoscopy and tracheal intubation. The incidence of nausea and vomiting in post-operative care unit wasrecorded too. Results: Hemodynamic variables were comparable in twogroups. No event of irreversible respiratory depression, desaturation, need forpositive pressure ventilation and hallucination was observedin group B. All patients were cooperative and obedient during the laryngoscopyand tracheal intubation. The incidence of nausea was not statisticallysignificant. The anesthesiologist was satisfied by the quality of patient’s cooperation for laryngoscopy in both groups. Conclusion: Subcutaneous dissociativeconscious sedation is comparable with general anesthesia to provide desirablesituation for laryngoscopy and tracheal intubation.

KEYWORDS

Difficult Airway; Ketamine; Laryngoscopy; Subcutaneous Dissociative Conscious Sedation; Tracheal Intubation

Cite this paper

S. Shabani, M. Javid and J. Zebardast -The Feasibility of Endotracheal Intubation with Subcutaneous Dissociative Conscious Sedation versus General Anesthesia: A Prospective Randomized Trial,- Open Journal of Anesthesiology, Vol. 4 No. 2, 2014, pp. 41-45. doi: 10.4236-ojanes.2014.42006.





Author: Sanaz Shabani, Mihan J. Javid, Jayran Zebardast

Source: http://www.scirp.org/



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