Dexmedetomidine in the Management of Awake Fiberoptic Intubation

Aniello Alfieri1, *, Maria B. Passavanti1, Sveva Di Franco1, Pasquale Sansone1, Paola Vosa2, Francesco Coppolino1, Marco Fiore1, Caterina Aurilio1, Maria C. Pace1, Vincenzo Pota1
1 Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
2 Unit of Pediatric Intensive Care and Neurosurgery. A.O.R.N. Santobono-Pausillipon, Naples, Italy

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© 2019 Alfieri et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy; Tel: 00390815665178; Email:


Awake Fibreoptic Intubation (AFOI) is, nowadays, the gold standard in predicted difficult airway management. Numerous practice guidelines have been developed to assist clinicians facing with a difficult airway. If conducted without sedation, it is common that this procedure may lead to high patient discomfort and severe hemodynamic responses. Sedation is frequently used to make the process more tolerable to patients even if it is not always easy to strike a balance between patient comfort, safety, co-operation, and good intubating conditions. In the last years, many drugs and drug combinations have been described. This minireview aims to discuss the evidence supporting the use of Dexmedetomidine (DEX) in the AFOI management.

Keywords: Dexmedetomidine, Fiberoptic intubation, Airway management, Hemodynamic responses, Sedation, Gold standard.