Effects Of Intranasal Dexmedetomidine For Premedication On Preoperative Anxiety And Emergence Delirium After Sevolfurane Anesthesia In Children

Objective Perioperative anxiety and emergence delirium is a common phenomenonin children because of separating from parents, anesthetic technique,environment andother factors. Dexmedetomidine is a highly specific and selective alpha-2-adrenergicagonist with sedative, anxiolytic,and analgesic effects. This study was to observe theeffects of intranasal dexmedetomidine for premedication on preoperative anxiety andemergence delirium after sevoflurane anesthesia in children.Methods Sixty of1-4year-old children under-going hernia surgery undersevoflurane anesthesia were randomly assigned to one of three groups(20in eachgroup):： I, Ⅱ, Ⅲ. Group I received intranasal placebo(normal saline)0.4ml.Group Ⅱand Group Ⅲ received intranasal dexmedetomidine0.5ug/kg or1ug/kg, respectively.Intranasal dexmedetomidine was prepared to make a final volume of0.4ml. An equalvolume was dripped into each nostril. After30minutes all children entered into theoperating room for induction of anesthesia with their parents. attendinganesthesiologists were blinded to the study drug given. Patients sedation status wasassessed when the children into the operating room. BP, HR, SPO2,ETsevo weremeasured during the operation.Times to induction, anesthesia and emergence, adversereactions, agitation scores were observed and recorded.Agitation scores wereobserved at eye-opening immediate, after eye-opening5,15and30min.Results The proportion of children with sedation scores>3was higher in Group Ⅲ(45%) than in Group I and Droup II (10%and15%)(P <0.05). In group III, the times to induction and agitation score was significantly lower than in group I and group II (P<0.01). The sedation scores and the agitation scores were no significant differencesbetween group I and group II. The agitation scores at T0and T1was significantlyhigher than its at T2and T3in group I and group II. The agitation scores was nosignificant difference in group III.Times to eye-opening were no significantdifferences among3groups（P>0.05）.Conclusion intranasal dexmedetomidine1ug/kg for premedication is effective onanxious relief and decreases the incidence of emergence delirium without delayingthe awakening time.