Effects of different doses of intranasal dexmedetomidine on preoperative sedation and postoperative agitation in pediatric with total intravenous anesthesia undergoing adenoidectomy with or without tonsillectomy

Autor: Li-Qin Li, Cong Wang, Hou-Zhong Zhang, Hong-Liu Lu, Hong-Yu Xu
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Agonist
Male
adenotonsillectomy
pediatrics
medicine.drug_class
premedication
Sedation
medicine.medical_treatment
postoperative emergence agitation
Observational Study
Anesthesia
General
law.invention
Adenoidectomy
03 medical and health sciences
0302 clinical medicine
Emergence Delirium
Randomized controlled trial
Double-Blind Method
030202 anesthesiology
law
Anxiety
Separation
Medicine
Humans
Hypnotics and Sedatives
Dexmedetomidine
Child
intravenous anesthesia
Administration
Intranasal
Psychomotor Agitation
Tonsillectomy
Pain
Postoperative
business.industry
Total intravenous anesthesia
dexmedetomidine
030208 emergency & critical care medicine
General Medicine
sedation
Patient Satisfaction
Anesthesia
Child
Preschool
Nasal administration
Female
medicine.symptom
business
medicine.drug
Research Article
Zdroj: Medicine
ISSN: 1536-5964
0025-7974
Popis: Dexmedetomidine is a highly selective α2 receptor agonist, this study aimed to investigate the effects of different doses of intranasal dexmedetomidine on the preoperative sedation and postoperative agitation in pediatric with total intravenous anesthesia (TIVA) for adenoidectomy with or without tonsillectomy. This is a double-blind placebo-controlled randomized trial. Pediatric were randomly divided into the D1, D2, and S groups, each group contained 30 patients. Twenty-five to 40 minutes before surgery, the D1 and D2 groups received intranasally dexmedetomidine 1 μg kg−1 or 2 μg kg−1, respectively, while the S group received saline of the same volume. A unified protocol of TIVA induction and maintenance was used for the three groups. The preoperative sedation, behavior of separation from parents, postoperative agitation, and postoperative pain of the children were evaluated. The proportions of satisfactory sedation in the D1, D2, and S groups were 63.3%, 76.7%, and 0%, respectively. There was a statistically significant difference between D1 and S groups (P = .000) and D2 versus S groups (P = .000), while there was no statistically significant difference between D1 and D2 groups (P = .399). As for scale on the behavior of separation from parents, there was a statistically significant difference between D1 and S groups (P = .009) and D2 versus S groups (P = .009), whereas there was no significant difference between D1 and D2 groups (P = 1). The incidence of postoperative agitation in the D1, D2, and S groups was 43.3%, 30.0%, and 63.3%, respectively, and there was a statistical difference between D2 and S groups (P = .010). There was a significant difference in the Pediatric Anesthesia Emergence Delirium (PAED) scale between D2 and S groups (P = .029). The Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) in the D2 group was significantly lower than the S group (P = .013). The intranasal dexmedetomidine of 1 or 2 μg kg−1 25 to 40 minute before induction of anesthesia both could deliver effective preoperative sedation, reducing the children's distress of separation from parents. Moreover, intranasal dexmedetomidine of 2 μg kg−1 could deliver more effective postoperative analgesia and reduce postoperative agitation, without prolonging postoperative recovery or causing severe adverse events.
Databáze: OpenAIRE
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