Intranasal dexmedetomidine premedication reduces minimum alveolar concentration of sevoflurane for laryngeal mask airway insertion and emergence delirium in children: a prospective, randomized, double‐blind, placebo‐controlled trial. Issue 5 (8th December 2014)

• Record Type: Journal Article
• Authors: Yao, Yusheng; Qian, Bin; Lin, Ying; Wu, Weilan; Ye, Huazhen; Chen, Yanqing; Lerman, Jerrold
• Is Part Of: Paediatric anaesthesia. Volume 25:Issue 5(2015)
• Page Start: 492
• Page End: 498
• Publication Date: 2014-12-08
• Subjects: Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.12574
• Languages: English
• ISSNs: 1155-5645

Abstract

<abstract abstract-type="main" id="pan12574-abs-0001"> <title>Summary</title> <sec id="pan12574-sec-0001" sec-type="section"> <title>Background</title> <p>We conducted a prospective, randomized, double‐blind, placebo‐controlled study to verify the hypothesis that intranasal dexmedetomidine premedication can reduce the minimum alveolar concentration of sevoflurane for laryngeal mask airway insertion in children.</p> </sec> <sec id="pan12574-sec-0002" sec-type="section"> <title>Methods</title> <p>Ninety American Society of Anesthesiologists (ASA) physical status I subjects, aged 3–7 years, were randomized to three equal groups to receive saline (Group S), dexmedetomidine 1 μg·kg<sup>−1</sup> (Group D<sub>1</sub>), or dexmedetomidine 2 μg·kg<sup>−1</sup> (Group D<sub>2</sub>) approximately 45 min before anesthesia. The minimum alveolar concentration for laryngeal mask airway insertion of sevoflurane was determined according to the Dixon's up‐and‐down method. Emergence delirium was evaluated using the Pediatric Anesthesia Emergence Delirium (PAED) scale in the postanesthesia care unit (PACU).</p> </sec> <sec id="pan12574-sec-0003" sec-type="section"> <title>Results</title> <p>Dexmedetomidine premedication of 1 and 2 μg·kg<sup>−1</sup> was associated with reduction in sevoflurane from 1.92% to 1.53% and 1.23%, corresponding to decrease of 20% and 36%, respectively. The peak PAED scores (median [IQR]) were 9 [8–11.5], 5 [3–5.3], and 3 [2–4] in Group S, Group D<sub>1, </sub> and Group D<sub>2</sub>, respectively. The incidence of emergence delirium (defined as peak PAED score ≥10) was significantly lower in Groups D<sub>1</sub> and D<sub>2</sub> than in Group S (<italic>P </italic><<italic> </italic>0.001). Simultaneously, the induction qualities and the parent's satisfaction scores were significantly higher in Groups D<sub>1</sub> and D<sub>2</sub> than in Group S (<italic>P </italic><<italic> </italic>0.001).</p> </sec> <sec id="pan12574-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Intranasal dexmedetomidine premedication produces a dose‐dependent decrease in the minimum alveolar concentration for laryngeal mask airway insertion of sevoflurane and emergence delirium in the PACU.</p> </sec> </abstract>