A Comparative Evaluation of Intranasal Dexmedetomidine &amp; Intranasal Midazolam for Pre-Operative Sedation in Children

Ghosh, Alakendu; Das, Asoke Kumar; Mukherjee, Maitreyee; Bagum, Sabnam Ara; Chatterjee, Subir K.

doi:10.14260/jemds/2020/159

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…3 At a dose of 1 to 1.5 µg/ kg, it produces a sedative effect within 45 to 60 minutes and reaches a peak at 90 to 105 minutes. 19 Although dexmedetomidine is not indicated for use in pediatrics, its application in sedation in children has been greatly increased because of its advantages such as relatively preserved airway tone and respiratory drive. 20,21 In cardiac surgery, dexmedetomidine has been successfully used for sedation and analgesia in the pediatric ICU after cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

The Safety and Efficacy Evaluation of Dexmedetomidine for Procedural Sedation and Postoperative Behaviors in Pediatric Populations: A Systematic Review and Meta-analysis

2021

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Background: This study systematically evaluated the safety and efficacy of dexmedetomidine for procedural sedation and postoperative behaviors in a pediatric population as well as whether the results met the information required to draw conclusions. Objective: To evaluate the safety and efficacy evaluation of dexmedetomidine for procedural sedation and postoperative behaviors in a pediatric population. Methods: PubMed, Cochrane library, Web of Science and Ovid MEDLINE were searched to obtain randomized controlled trials (RCTs) comparing dexmedetomidine with control medicine and comparing different doses of dexmedetomidine. Results: There were a total of 16 RCTs for a total of 3240 patients. Dexmedetomidine slowed down the heart rate (HR; mean difference: −13.27; 95% CI: −16.41 to 10.14; P < 0.001) and reduced postoperative delirium (risk ratio [RR]: 0.31; 95% CI: 0.20-0.50; P < 0.001), the number of pain patients (RR: 0.48; 95% CI: 0.30-0.75; P = 0.002), and desaturation (RR: 0.34; 95% CI: 0.13-0.89; P = 0.03) compared with the control group. The limitation was that it was difficult to determine the range of low- and high-dose dexmedetomidine. Conclusion and Relevance: Dexmedetomidine slowed down intraoperative HR within the normal range, which might reduce myocardial oxygen consumption. It reduced postoperative pain and postoperative complications: delirium and desaturation. Dexmedetomidine showed no dose-dependent increase in the procedural sedation time of pediatric patients. Clinically, dexmedetomidine can improve pediatric procedural sedation and postoperative behavior, and it can be considered as a related medicine for safety in pediatric surgery.

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