Effectiveness of Intranasal Dexmedetomidine for Sedation in Children

Abstract

Background: Preoperative sedation in children is necessary as it is a common source of distress, potentially leading to difficult induction. Intranasal dexmedetomidine bypasses hepatic metabolism and has good availability. It is non invasive, easy with minimal respiratory depression. This study aimed to observe safety, efficacy, sedation level and parental separation score following a fixed dose of 1.5 mcg/kg
Methods: A cross sectional study design was conducted among 43 children posted for elective surgeries. After informed consent and assent were obtained, intranasal DEX 1.5mcg/kg was administered. Satisfactory sedation was defined as a Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score of ? 3, and satisfactory parental separation as a score of ? 2 on a 4-point scale. Physiological parameters (HR, RR, SPO2 were monitored for 30 minutes. Statistical analysis involved the use of SAS version 9.4.
Results: Satisfactory sedation ? 3 was achieved in 93.0% of subjects by 30 minutes (95% CI: 80.9%–98.5%). Similarly, satisfactory parent-child separation ? 2 score was achieved in 93.0% of subjects. Mean heart rate progressively decreased from 107.12±14.20 at baseline to 85.47 ± 7.29 beats per minute at 30 minutes, which was well tolerated.
Conclusions: Intranasal DEX at a dose of 1.5 mcg/kg is safe and effective premedication for paediatric patients, which results in successful sedation with tolerated changes in vitals.
Keywords: Dexmedetomidine; intranasal; paediatric; premedication; sedation.