The Effects Of Ketamine On The Quality Of Sedation Of Intranasal Dexmedetomidine Premedication In Children

Objective: To observe the effects of ketamine on the quality of sedation of intranasal dexmedetomidine premedication in children’s tonsillectomy.Methods: Sixty children(both boys and girls) were engaged in this study, who were with ASA physical status I or II, aged between 3 and 7 years old and scheduled to undergo elective tonsillectomy. The subjects were randomly divided into two groups with thirty children each. Group Dexmedetomidine(Group D)received premedication of dexmedetomidine 2ug/kg 45 min before induction by LMA MAD. Group Dexmedetomidine + Ketamine(Group DK) received premedication of intranasal combined dexmedetomidine 2ug/kg and ketamine 2mg/kg. Sedation status was evaluated by the observer using the Modified Observer’s Assessment of Alertness/Sedation Scale(MOAA/S) at 30 min after premedication. Patient’s response to separation from parents was assessed by the Parental Separation Anxiety Scale(PSAS), about 30 minutes after medication administration. The Patient’s mask acceptance was evaluated by Mask Acceptance Scale(MAS). Vital signs were continuously monitored and recorded every 15 min until the child was ready to be discharged. Bradycardia and hypotension(30% lower than the basic value) need to be recored during the operation. The observer recorded the oneset time, the time of extubation, duration of PACU stay, postoperative agitation, and the incidence of adverse effects, such as nausea,vomiting.Result: Group D and Group DK were significantly different in MOAA/S scores and MAS scores(P<0.05). The PSAS scores of Groups D and DK were comparable. The oneset time was significantly shorter in Group DK than Group D. the time of extubation and duration of PACU stay of Groups D and DK were comparable. The two groups did not appear obvious bachycardia and hypotension.Conclusion: The quality of sedation of intranasal dexmedetomidine and ketamine premedication is better than the single use of dexmedetomidine.