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Comparative efficacy of three different doses of intranasal dexmedetomidine for premedication in children

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Original Article

Author Details : Kuldeep Singh, Neelam Prasad*, Munisha Agarwal, Rakesh Kumar, Moushumi Saha

Volume : 9, Issue : 4, Year : 2022

Article Page : 409-414

https://doi.org/10.18231/j.ijca.2022.084

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Abstract

Background: Preoperative emotional distress in children should be addressed properly for better anesthetic experience. The present study was a Prospective randomized double-blind study to evaluate comparative efficacy of three different doses of intranasal dexmedetomidine for premedication in children.
Materials and Methods:  Sixty children were then randomly allocated to one of the three groups of 20 each by a computer generated table. The drug was administered 45 minutes prior to induction of anesthesia intra-nasally. Following intra-nasal drug administration, anxiety was assessed at 0 minutes -baseline, 30 minutes, 45 minutes and at parental separation in the preoperative area just before shifting in operation theater using the mYPAS (modified Yale Preoperative Anxiety Scale). At induction, induction compliance was assessed using the induction compliance checklist and heamodynamic response to definitive airway was assessed.
Results: It was observed that intranasal dexmedetomidine in lower doses of 0.5 and 1µg/kg was effective in reducing anxiety from baseline values but was not sufficient for providing anxiolysis at the most stressful time - at parental separation and shifting to OR (Operating room). The dosage of 1.5µg/kg was found to be the most effective dose for allaying preoperative anxiety without any adverse effect. However, this dose was insufficient for optimizing induction as it is mainly anxiolytic and higher doses having additional sedative action may be required to make the child more compliant for induction of anesthesia.
Conclusions: Based on our findings, we recommend that intranasal dexmedetomidine in the dose of 1.5µg/kg can be used for allaying preoperative anxiety, without any adverse events.
Key Points Summary: • Question: To evaluate and compare the efficacy of three different doses of intranasal dexmedetomidine for premedication in children for preoperative anxiety using the mYPAS scale. • Findings: Dose of 1.5µg/kg can be used for allaying preoperative anxiety, without any adverse events. • Meaning: Optimum dose of intranasal dexmeditomedine which is efficient to allay preoperative anxiety in children.

Keywords: Intranasal dexmedetomidine, Premedication.

How to cite : Singh K, Prasad N, Agarwal M, Kumar R, Saha M, Comparative efficacy of three different doses of intranasal dexmedetomidine for premedication in children. Indian J Clin Anaesth 2022;9(4):409-414

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