Turunc Esra, Ustun Yasemin Burcu, Bilgin Sezgin, Kaya Cengiz, Koksal Ersin, Dost Burhan
Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Kurupelit, Samsun, TR55139, Turkey.
BMC Anesthesiol. 2025 May 3;25(1):227. doi: 10.1186/s12871-025-03106-x.
Pediatric patients undergoing upper gastrointestinal (GI) interventions frequently require sedation and analgesia due to the challenges associated with endoscopic probe placement, particularly the gag reflex. This study investigates the effects of nebulized dexmedetomidine as a premedication on the gag reflex in pediatric patients undergoing gastrointestinal endoscopy.
We conducted a single-center, prospective, randomized controlled trial at the Pediatric Gastroenterology Clinic of Ondokuz Mayis University School of Medicine from January to April 2024. Participants aged 2-17 years scheduled for upper GI endoscopy were randomized to receive nebulized dexmedetomidine (2 µg /kg) or no premedication. The primary outcome measured was the severity of the gag reflex during the procedure. Secondary outcomes included cough incidence, separation anxiety, postoperative agitation, and endoscopist satisfaction. Statistical analyses were performed with significance set at p < 0.050.
A total of 120 patients were analyzed. The dexmedetomidine group demonstrated a significantly lower incidence of gag reflex (88.3% with no gag reflex vs. 30% in the control group, p < 0.001) and coughing (95% vs. 55%, p < 0.001). Separation anxiety scores were also significantly lower in the dexmedetomidine group (p < 0.005). Additionally, the need for additional anesthetics was reduced, and endoscopist satisfaction was significantly higher. No significant differences in complications were observed between the two groups (p = 0.600).
Nebulized dexmedetomidine is a safe and effective premedication for pediatric patients undergoing endoscopic procedures, significantly reducing gag and cough reflexes, decreasing anesthetic requirements, and enhancing endoscopist satisfaction. This approach improves the comfort and safety of pediatric endoscopy procedures.
ClinicalTrials.gov: NCT06218797, date of registration 27/12/2023.
由于上消化道（GI）干预操作中内镜探头放置存在挑战，尤其是咽反射，接受此类操作的儿科患者经常需要镇静和镇痛。本研究调查雾化右美托咪定作为术前用药对接受胃肠内镜检查的儿科患者咽反射的影响。
2024年1月至4月，我们在翁多库兹马伊大学医学院儿科胃肠病诊所进行了一项单中心、前瞻性、随机对照试验。计划接受上消化道内镜检查的2至17岁参与者被随机分为接受雾化右美托咪定（2μg/kg）或不进行术前用药。测量的主要结局是操作过程中咽反射的严重程度。次要结局包括咳嗽发生率、分离焦虑、术后躁动和内镜医师满意度。进行统计学分析，显著性设定为p<0.050。
共分析了120例患者。右美托咪定组咽反射发生率（无咽反射者占88.3%，对照组为30%，p<0.001）和咳嗽发生率（95%对55%，p<0.001）显著更低。右美托咪定组的分离焦虑评分也显著更低（p<0.005）。此外，额外麻醉剂的需求减少，内镜医师满意度显著更高。两组之间并发症无显著差异（p=0.600）。
雾化右美托咪定是接受内镜检查的儿科患者安全有效的术前用药，可显著降低咽反射和咳嗽反射，减少麻醉需求，并提高内镜医师满意度。这种方法提高了儿科内镜检查操作的舒适度和安全性。
ClinicalTrials.gov：NCT06218797，注册日期2023年12月27日。
