Messeha Medhat M, El-Morsy Gamal Zakaria
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Anesth Essays Res. 2018 Jan-Mar;12(1):170-175. doi: 10.4103/aer.AER_119_17.
The intranasal route is a reliable way to administer preanesthetics and sedatives to children. The aim of this study was to compare the anxiolytic and sedative effect of intranasal dexmedetomidine and midazolam as a premedication in pediatrics with simple congenital heart disease undergoing cardiac catheterization.
Sixty children 3-6 years old of either sex with simple congenital heart disease undergoing cardiac catheterization were randomly allocated into two groups: Dexmedetomidine group who received intranasal dexmedetomidine (0.1 μg/kg) and midazolam group who received intranasal midazolam (0.2 mg/kg) 30 min before induction. Heart rate, mean arterial blood pressure, and oxygen saturation were monitored up to 30 min after drug administration. The sedation score, anxiety score, and child-parent separation score were recorded until the child taken to the operating room. The postoperative agitation score was also observed.
The premedication of children with intranasal dexmedetomidine attained satisfactory and significant sedation and lower anxiety level with better parental separation than those who received intranasal midazolam.
经鼻途径是给儿童使用麻醉前用药和镇静剂的可靠方法。本研究的目的是比较经鼻给予右美托咪定和咪达唑仑作为术前用药对患有简单先天性心脏病并接受心导管插入术的儿科患者的抗焦虑和镇静效果。
60例年龄在3至6岁、患有简单先天性心脏病并接受心导管插入术的儿童被随机分为两组：右美托咪定组，在诱导前30分钟接受经鼻给予右美托咪定（0.1μg/kg）；咪达唑仑组，在诱导前30分钟接受经鼻给予咪达唑仑（0.2mg/kg）。给药后30分钟内监测心率、平均动脉血压和血氧饱和度。记录镇静评分、焦虑评分和儿童与父母分离评分，直至儿童被送入手术室。还观察了术后躁动评分。
与接受经鼻咪达唑仑的儿童相比，经鼻给予右美托咪定对儿童进行术前用药可获得满意且显著的镇静效果，焦虑水平更低，与父母分离情况更好。
