Department of Anaesthesiology, Queen Mary Hospital, Pokfulam, Hong Kong, China.
Anaesthesia. 2012 Nov;67(11):1210-6. doi: 10.1111/j.1365-2044.2012.07309.x. Epub 2012 Sep 5.
We compared sedation levels in children following administration of intranasal dexmedetomidine. One hundred and sixteen children aged between 1 and 8 years were enrolled in this prospective, randomised trial. Children were assigned to receive either intranasal dexmedetomidine 1 μg.kg(-1) (Group 1) or 2 μg.kg(-1) (Group 2). Thirty-one (53%) patients from Group 1 and 38 (66%) patients from Group 2 were satisfactorily sedated at the time of anaesthetic induction. Logistic regression showed a significant interaction effect (p=0.049), with the odds ratio between Group 2 over Group 1 estimated as 1.1 (95% CI 0.5-2.7) for the 1-4 year age group, and 10.5 (95% CI 1.4-80.2) for the 5-8 year age group. Both doses produced a similar level of satisfactory sedation in children aged 1-4 years, whereas 2 μg.kg(-1) resulted in a higher proportion of satisfactory sedation in children aged 5-8 years. There were no adverse haemodynamic effects. We conclude that intranasal dexmedetomidine in a premedication dose of 2 μg.kg(-1) resulted in excellent sedation in children.
我们比较了经鼻给予右美托咪定后儿童的镇静水平。这项前瞻性随机试验纳入了 116 名年龄在 1 至 8 岁之间的儿童。儿童被分配接受 1 μg.kg(-1)(第 1 组)或 2 μg.kg(-1)(第 2 组)的经鼻右美托咪定。第 1 组有 31 名(53%)患者,第 2 组有 38 名(66%)患者在麻醉诱导时镇静满意。逻辑回归显示存在显著的交互效应(p=0.049),第 2 组的优势比估计为 1.1(95%CI 0.5-2.7),用于 1-4 岁年龄组,10.5(95%CI 1.4-80.2)用于 5-8 岁年龄组。两组在 1-4 岁儿童中均产生了相似水平的满意镇静,而 2 μg.kg(-1)在 5-8 岁儿童中产生了更高比例的满意镇静。没有不良的血液动力学影响。我们得出结论,在预给药剂量为 2 μg.kg(-1)时,经鼻给予右美托咪定可使儿童获得良好的镇静效果。