Alipour Mohammad, Ghanei Samira, Sheikh Shahrzad, Ghanei Masoud, Nemati Ahmad, Niroumand Shabnam
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
BMC Res Notes. 2025 Jan 2;18(1):1. doi: 10.1186/s13104-024-07072-4.
Using neuromuscular blocking agents (NMBA) in pediatric induction protocol is a challenging matter. Therefore, in this study, we aimed to find a safer way for anesthesia in children. We compared the effects of dexmedetomidine with atracurium on intubation conditions in children aged 6-12 years under general anesthesia. If dexmedetomidine has the similar effect as atracurium, we can use it for intubation and anesthesia of children in situations where the use of atracurium is challenging for any reason.
This clinical trial was carried out on children between 6 and 12 years in Mashhad University of Medical Sciences, Mashhad, Iran between January 2018 and February 2020. Participants candidates for tracheal intubation and general anesthesia were enrolled. Patients were distributed into two groups: Patients received Dexmedetomidine (Group D) and patients received Atracurium (Group A).
We enrolled 25 patients in each group. Most of them were male. The intubation quality score consists of 5 items including laryngoscopy, vocal cord, coughing, jaw relaxation and limb movement was assessed between two groups. This score had no statistically significant difference between study groups. Immediately after induction and one minute after it, heart rate was statistically significant higher in group A than group D (P < 0.001 & P = 0.04 respectively). All of the intubations in our study were successful. More coughing was seen in group A compared with group D (P = 0.01).
In children aged 6-12 years, the administration of intravenous dexmedetomidine 1mcg/kg over a period of 10 min before the induction of anesthesia with sufentanil 0.3 µg/kg and propofol 3 mg/kg showed no statistically significant difference in quality of intubation score when compared to the use of 0.5 mg/kg atracurium to facilitate intubation. Decreased heart rate and less coughing were observed when using dexmedetomidine. This trial was registered retrospectively in the Iranian Clinical Trials Registry at 2021-24-05 ( https://www.irct.ir/ ), and its registration number is IRCT20201028049177N1.
在儿科诱导方案中使用神经肌肉阻滞剂（NMBA）是一件具有挑战性的事情。因此，在本研究中，我们旨在找到一种更安全的儿童麻醉方法。我们比较了右美托咪定与阿曲库铵对6至12岁儿童全身麻醉下插管条件的影响。如果右美托咪定具有与阿曲库铵相似的效果，那么在因任何原因使用阿曲库铵具有挑战性的情况下，我们就可以将其用于儿童的插管和麻醉。
本临床试验于2018年1月至2020年2月在伊朗马什哈德医科大学对6至12岁的儿童进行。纳入气管插管和全身麻醉的候选参与者。患者被分为两组：接受右美托咪定的患者（D组）和接受阿曲库铵的患者（A组）。
我们每组纳入了25名患者。他们大多数为男性。对两组之间的插管质量评分进行评估，该评分由包括喉镜检查、声带、咳嗽、下颌松弛和肢体运动在内的5项组成。研究组之间该评分无统计学显著差异。诱导后即刻及诱导后1分钟，A组的心率在统计学上显著高于D组（分别为P < 0.001和P = 0.04）。我们研究中的所有插管均成功。与D组相比，A组出现更多咳嗽（P = 0.01）。
在6至12岁儿童中，在使用0.3μg/kg舒芬太尼和3mg/kg丙泊酚诱导麻醉前10分钟静脉注射1μg/kg右美托咪定，与使用0.5mg/kg阿曲库铵辅助插管相比，插管质量评分无统计学显著差异。使用右美托咪定时观察到心率降低且咳嗽减少。该试验于2021年5月24日在伊朗临床试验注册中心进行回顾性注册（https://www.irct.ir/），其注册号为IRCT20201028049177N1。
