Comparative effectiveness of intranasal dexmedetomidine dosing as premedication in paediatric surgery: Randomized controlled trial

Abstract

: The use of alpha 2 agonists are now becoming the standard of care pre-medication drug in paediatric patients to induce induction and reduce separation anxiety. A prospective, randomized, double-blind, controlled study was designed to assess and compare the effectiveness and safety of two different strengths of intranasal dexmedetomidine in children between the ages of 2 and 8.: Sixty children between ages 2-8 years and of ASA physical status I or II scheduled for elective surgery were randomly assigned to one of two groups. Group A received 1 µg/kg of intranasal dexmedetomidine while Group B received 2 µg/kg as pre-medication. Patients sedation status, behaviour (mask acceptance) and parental separation scores were assessed over 30 min as primary endpoints along with its effect on haemodynamic and respiratory parameters over the same duration as secondary endpoints.: 7.4% of children in group A while 96.5% of children in group B achieved a satisfactory sedation score, 11.1% of children in group A while 100% of children in group B achieved a satisfactory mask acceptance score and 7.4% of children in group A while 100% of children in group B achieved a satisfactory parent child separation score (p<0.001). We did not observe any clinically significant effects of dexmedetomidine on RR, SpO2, HR or MAP and no child required atropine or supplemental oxygen.: We conclude that 2µg/kg dose as compared to 1µg/kg offers multiple advantages of being good sedative, analgesic and anxiolytic in this age group when used as pre-medication.