Publication: Evaluation of stress response and anxiety scores of paediatric patients sedated with intranasal dexmedetomidine vs placebo: A randomized control trial
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Date
2022
Authors
Rajasingam, Dhivya
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Abstract
Background: Dexmedetomidine’s (DEX) favourable properties that include analgesia, sedation, and maintenance of cardiovascular stability renders it an ideal drug for paediatric patients. It provides a safer option with less concern for postoperative sedation and hangover effect. Furthermore, intranasal dexmedetomidine is tolerable and easily administered to paediatric patients. Methods: This was a prospective randomized controlled trial. A total of 60 paediatric patients who underwent elective surgery were included in the study and randomly assigned to receive either intranasal DEX (n = 30) or intranasal 0.9% normal saline (NS, n= 30). Primary outcomes measured the baseline serum cortisol level and serum cortisol postinduction of anaesthesia. Secondary outcomes included Modified Yale Preoperative Anxiety Scale scores, Sedation Behavior Scores (SBSs) and haemodynamic stability. Results: Both NS and DEX groups showed a significant increase in serum cortisol levels when compared with the baseline. Pairwise comparisons between the groups showed no significant difference in serum cortisol levels (95%CI 1.73(-57.28, 60.75); p = 0.95). Both NS and DEX groups showed significant improvement for SBS post sedation administration. There was a significant increase in post-induction of anaesthesia heart rate level in the NS group (95%CI – 10.23(-15.57, -4.90) p = 0.00); however, it was not significant in the DEX group (95% CI – 7.17(-15.405, 1.07); p = 0.09) Conclusion: At a dose of 1 mcg/kg, intranasal DEX provides a satisfactory level of anaesthesia for paediatric patients; however, it does not reduce the stress response to induction of anaesthesia
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Keywords
dexmedetomidine , general anaesthesia