Feasibility of using administration of intranasal dexmedetomidine for preoperative sedation in pediatric patients with congenital heart disease / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy and safety of administration of intranasal dexmedetomidine for preoperative sedation in the pediatric patients with congenital heart disease.Methods Sixty pediatric patients of both sexes,aged 2-5 yr,weighing 10-30 kg,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅰ-Ⅲ),scheduled for elective radical operation for congenital heart disease under general anesthesia,were randomly divided into 2groups (n =30 each) using a random number tabledexmedetomidine administered intranasally group (group IN) and dexmedetomidine administered intravenously group (group Ⅳ).After admission to a room for preoperative preparation,dexmedetomidine 2μg/kg was administered intranasally in group IN and dexmedetomidine 0.5 μg/kg (in 15,ml normal saline) was injected intravenously over 20 min in group Ⅳ.After admission to the operating room at 20 min after administration,oxygen was inhaled through a face mask and induction of anesthesia was performed.The patient acceptance of modes of administration,sedation degree at 20 min after administration,score of mood state of the children when they were separated from their parents,and degree of patient acceptance of oxygen inhalation via a face mask were recorded.Bradycardia,hypotension,hypertension and hyoxemia were recorded from administration to induction of anesthesia.Results Compared with IN group,the rate of patient acceptance of modes of administration was significantly decreased,and no significant changes were found in sedation degree at 20 min after administration,score of mood state of the children when they were separated from their parents,and degree of patient acceptance of oxygen inhalation via a face mask in group Ⅳ.No adverse reactions such as bradycardia,hypotension,hypertension or hyoxemia developed from administration to induction of anesthesia in the two groups.Conclusion Dexmedetomidine 2μg/kg administered intranasally can be safely and effectively used for preoperative sedation in the pediatric patients with congenital heart disease.