Dexmedetomidine as an anaesthetic adjunct for management of difficult airway in a patient with facial injury following bear maul

Abstract : The management of difficult airway is one of the most challenging tasks for the anaesthesiologist. Life threatening cannot intubate and cannot ventilate situation can be avoided by performing awake-fibreoptic intubation. Although there are many techniques described for fibreoptic intubation but relative merits and demerits of each technique should be considered. The key to successful awake- fibreoptic intubation depends upon the meticulous preparation of the patient and the equipments. Many methods of sedation have been described but theirs side effects are the limitations. Dexmedetomidine, a selective alpha2 adrenergic agonist, has unique property of conscious sedation. Besides, dexmedetomidine has additional property of analgesia, reflex blunting and anti-sialogogue, which can further improve the success rate of awake-fibreoptic intubation in cases with difficult airway. We described a case of bear maul of face with anticipated difficult airway successfully conducted awake-fibreoptic intubation with the use of dexmedetomidine.