The effect of intranasal dexmedetomidine premedication in children undergoing adenotonsillectomy suffering from recent mild upper respiratory tract infection

Abstract

Background: Pediatric patients are susceptible to significant levels of stress and anxiety during the phase of perioperative. The use of sedative premedication has the potential to mitigate the levels of anxiety and emotional distress experienced by individuals. The use of dexmedetomidine and midazolam as preoperative sedatives for pediatric patients has been more prevalent in recent years. However, the impact of these sedatives on postoperative respiratory adverse events (PRAEs) remains uncertain.Objectives and Aims: The objective of this research is to assess the effectiveness of intranasal dexmedetomidine as a premedication for general anesthesia in pediatric patients who are having adenotonsillectomy and have respiratory comorbidities.Methods and Subjects: The present research was conducted at Tanta University Hospitals, specifically in the Department of Anesthesiology. It used a prospective double-blind randomized controlled trial (RCT) and focused on pediatric patients who were scheduled to undergo adenotonsillectomy and had a recent mild infection of upper respiratory tract.Results: A statistically important variance was observed among the groups under study in terms of Total PRAEs. Additionally, a comparison among the two group’s revealed differences in heart rate (HR), excluding the baseline HR, as well as at fifteen minutes post sedation, thirty minutes post sedation, at induction, fifteen minutes intraoperatively, and thirty minutes intraoperatively in terms of mean arterial blood pressure (MAP) measured in millimeters of mercury (mmHg).Conclusion: The results of this research indicate that intranasal administration of dexmedetomidine might effectively induce sedation before to surgery and perhaps mitigate the risk of PRAEs.