Proposal for a Protocol for Awake Fiberoptic Intubation in Adult with Dexmedetomidine

Many agents, including fentanyl, remifentanil, midazolam and propofol, have been reported to assist with AFOI. However, these agents can cause respiratory arrest, loss of or reduced (heart) function, especially when used in high doses, thus increasing the of low oxygen levels (hypoxemia), aspiration, low blood pressure (hypotension) or slow heart rate (bradycardia). Ideally, sedation should be administered by another anesthetist and its effects closely monitored. An awake, calm, alert patient will follow commands and can aid the intubator by taking deep breaths or protruding their tongue.