Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
Department of Research, U.N. Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
Ann Card Anaesth. 2021 Apr-Jun;24(2):224-229. doi: 10.4103/aca.ACA_17_20.
Procedural sedation required to improve the quality of Transthoracic Echocardiography (TTE) in infants and children. The ideal drug and route for sedation in children should have a rapid and reliable onset, atraumatic, palatable with minimal side effects, and rapid recovery. So, the aim of our study to evaluate and compare the efficacy and safety of intranasal midazolam and intranasal dexmedetomidine in pediatric patients for sedation during TTE.
Hundred children under three year of age, belonging to the American Society of Anaesthesiologists class-I and II, scheduled for TTE were divided into two groups by standard randomization technique. Patients in group-M received intranasal midazolam 0.2 mg/kg, whereas patients in group-D received intranasal dexmedetomidine 2 μg/kg prior to TTE under an adequately monitored anesthesia care. Onset and duration of sedation, heart rate, oxygen saturation, sonographer's, and parent's satisfaction scores were recorded.
All patients were successfully sedated for TTE. The average onset time, sedation time, awakening time and total time for Group-M were 7.3, 18.8, 29.51, 51 min and group-D were 10.1, 14.2, 24.9, 46.3 min, respectively and all were statistically significant (P < 0.001). TTE scan time of Group-M is 8.84 min and Group-D is 9.18 min and was statistically significant. Sonographer's and Parent's average satisfaction score for Group-M was 9.88, 10 and for Group-D was 7.64, 8.76, respectively, which were statistically significant (P < 0.001).
Intranasal midazolam and dexmedetomidine are safe and effective for sedation in TTE. Intranasal midazolam was found to be comparatively more effective in view of onset of action, sonographers, and parental satisfaction score, while sedation time, awakening time and total duration was significantly higher as compared to intranasal dexmedetomidine.
为了提高经胸超声心动图（TTE）的质量，需要进行程序性镇静。对于儿童，理想的镇静药物和途径应具有快速可靠的起效时间、无创伤、口感好、副作用最小且恢复迅速。因此，我们的研究旨在评估和比较鼻内咪达唑仑和鼻内右美托咪定在儿科患者 TTE 镇静中的疗效和安全性。
100 名年龄在 3 岁以下、美国麻醉医师协会（ASA）分级 I 和 II 的患儿，通过标准随机分组技术分为两组。M 组患儿接受鼻内咪达唑仑 0.2mg/kg，D 组患儿接受鼻内右美托咪定 2μg/kg，然后在充分监测的麻醉护理下进行 TTE。记录镇静开始时间、持续时间、心率、氧饱和度、超声医师和家长的满意度评分。
所有患儿均成功镇静用于 TTE。M 组的平均起效时间、镇静时间、觉醒时间和总时间分别为 7.3、18.8、29.51 和 51 分钟，D 组分别为 10.1、14.2、24.9 和 46.3 分钟，均有统计学意义（P<0.001）。M 组的 TTE 扫描时间为 8.84 分钟，D 组为 9.18 分钟，有统计学意义。M 组超声医师和家长的平均满意度评分为 9.88、10，D 组分别为 7.64、8.76，有统计学意义（P<0.001）。
鼻内咪达唑仑和右美托咪定用于 TTE 镇静是安全有效的。鼻内咪达唑仑在起效时间、超声医师和家长满意度评分方面表现出更好的效果，而镇静时间、觉醒时间和总持续时间明显高于鼻内右美托咪定。
