Intranasal dexmedetomidine prevents the emergence delirium in children after sevoflurane-based anesthesia / 中国医师杂志

ABSTRACT

Objective To investigate whether intranasal dexmedetomidine prevents the emergency delirium after sevoflurane-based anesthesia (ASA) in children.Methods Ninety children (ASA I,2 to 7years) undergoing elective tonsillectomy with or without adenoidectomy,were randomly divided into group D1 (intranasal dexmedemidine 1.0 μg/kg),group D2 (intranasal dexmedemidine 0.5 μg/kg),and group NS (intranasal normal saline).Anesthesia was induced with sevoflurane (30 min after intranasal administration) and maintained with sevoflurane in 50/50％ O2/N2O.Heart rate (HR),blood pressure (BP),and hemoglobin oxygen saturation (SpO2) were monitored before intranasal administration to 2 hours after extubation.Time of operation and extubation were recorded.Pediatric anesthesia emergence delirium (PAED) scale,Modified Children's Hospital of Eastern Ontario Pain Scale (m-CHEOPS) Pain scale and the adverse effects were observed.Results The PAED scales of group D1 and Group D2 were significantly lower than group NS.No significant differences were found in hemodynamic and respiratory variables,pain scale,time of extubation and adverse effects among three groups.Conclusions Intranasal dexmedetomidine decreased the severity of emergence delirium after sevoflurane-based anesthesia in children without prolonging the time to extubate and affect hemodynamics and respiratory variables.