Cimen Z Serhan, Hanci Ayse, Sivrikaya G Ulufer, Kilinc Leyla T, Erol Melahat K
Department of 2nd Anesthesiology and Reanimation, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Paediatr Anaesth. 2013 Feb;23(2):134-8. doi: 10.1111/pan.12025. Epub 2012 Sep 18.
Alpha-2 adrenergic agonists are used to premedicate pediatric patients to reduce separation anxiety and achieve calm induction. The clinical effects of clonidine are similar whether via the oral or nasal route. However, oral dexmedetomidine is not preferred because of its poor bioavailability. The objective of this study was to evaluate the effects of nasal versus buccal dexmedetomidine used for premedication in children.
Sixty-two patients, aged 2-6 years, undergoing minor elective surgery were randomly assigned to two groups to receive dexmedetomidine, either 1 μg·kg(-1) buccally (group B) or 1 μg·kg(-1) intranasally (group N) for premedication 45 min before the induction of anesthesia. Heart rate, peripheral oxygen saturation, and respiratory rate were measured before and every 10 min after administering dexmedetomidine in all children. Level of sedation was assessed every 10 min until transport to operating room. Drug acceptance, parental separation, and face mask acceptance scores were recorded.
There was no significant difference between the two groups in patient characteristics, nor was there any significant difference between the two groups in heart rate, respiratory rate, or SpO(2) values at all times after premedication. Levels of sedation, parental separation, and mask acceptance scores were significantly higher in group N than in group B at the various times.
These results suggest that intranasal administration of 1 μg·kg(-1) dexmedetomidine is more effective than buccal administration of 1 μg·kg(-1) dexmedetomidine for premedication in children.
α-2肾上腺素能激动剂用于小儿患者术前用药，以减轻分离焦虑并实现平稳诱导。可乐定经口服或鼻腔给药的临床效果相似。然而，口服右美托咪定因其生物利用度差而不被首选。本研究的目的是评估鼻腔给药与颊部给药的右美托咪定用于小儿术前用药的效果。
62例年龄在2至6岁之间接受择期小手术的患者被随机分为两组，在麻醉诱导前45分钟接受右美托咪定术前用药，一组为颊部给药1μg·kg(-1)（B组），另一组为鼻腔给药1μg·kg(-1)（N组）。在所有儿童中，于给予右美托咪定之前及之后每隔10分钟测量心率、外周血氧饱和度和呼吸频率。每隔10分钟评估镇静水平，直至转运至手术室。记录药物接受度、父母分离情况及面罩接受度评分。
两组患者的特征无显著差异，术前用药后各时间点两组的心率、呼吸频率或SpO(2)值也无显著差异。在各个时间点，N组的镇静水平、父母分离及面罩接受度评分均显著高于B组。
这些结果表明，对于小儿术前用药，鼻腔给予1μg·kg(-1)右美托咪定比颊部给予1μg·kg(-1)右美托咪定更有效。
