The sedative effects and the attenuation of cardiovascular and arousal responses during anesthesia induction and intubation in pediatric patients: a randomized comparison between two different doses of preoperative intranasal dexmedetomidine

作者：Shan‐Shan Wang, Mazhong Zhang, Ying Sun, Chi Wu, Wenyin Xu, Jie Bai, Meihua Cai, Lin Lin · 发表于：Pediatric Anesthesia · 年份：2013 · DOI：10.1111/pan.12284 · 被引用次数：45 · 研究领域：Anesthesia and Sedative Agents、Anesthesia and Neurotoxicity Research、Airway Management and Intubation Techniques

OBJECTIVE: Premedication with intranasal dexmedetomidine (DEX) has shown to be an effective sedative in pediatric patients. This prospective, randomized, and controlled investigation was designed to evaluate whether the difference in intranasal DEX dosing would produce different beneficial effects on the attenuation of cardiovascular and arousal responses during anesthesia induction and intubation. METHODS: Forty children, aged from 3 to 6 years, of American Society of Anesthesiologists physical status I or II and scheduled for elective adenotonsillectomy randomly received intranasal DEX 1 μg·kg(-1) (group D1) or 2 μg·kg(-1) (group D2) 30 min before anesthesia induction. Anesthesia was induced with sevoflurane in oxygen flow. Mean arterial pressure (MAP) and heart rate (HR) as measurements of cardiovascular response and bispectral index (BIS) as an index of arousal response were recorded every 5 min after intranasal DEX administration and measured every 1 min for 5 min after intubation. Sedation status, behavior scores, and mask induction scores were also assessed. RESULTS: Mean arterial pressure did not show statistical differences during the anesthesia induction, but did demonstrate significantly milder responses to laryngoscopy and intubation in group D2 compared with group D1. Change in HR was consistent with MAP during laryngoscopy and intubation. Patients who received 2 μg·kg(-1) DEX presented with deeper sedation and less anxiety by the assessments of the alertness sca...