Comparison of intubating conditions with combination of Fentanyl-Lidocaine-Propofol versus Fentanyl-Dexmedetomidine-Propofol in absence of neuromuscular blocking agent

This prospective randomized comparative study aims to evaluate whether the combination of Fentanyl–Dexmedetomidine–Propofol provides superior intubating conditions compared to Fentanyl–Lidocaine–Propofol during endotracheal intubation without neuromuscular blocking agents in ASA I–II adults aged 18–60 years undergoing elective surgery under general anesthesia. A total of 56 patients will be randomized into two groups, receiving either fentanyl with lidocaine or fentanyl with dexmedetomidine prior to induction with propofol, and intubating conditions will be assessed using the Viby–Mogensen scoring system along with monitoring hemodynamic responses for 5 minutes post-intubation. The study seeks to determine which drug combination better suppresses airway reflexes, provides smoother intubation, and maintains greater hemodynamic stability, while also observing any adverse events and the need for rescue muscle relaxants. The findings aim to guide safe and effective intubation practices when neuromuscular blockers are contraindicated or undesirable.