Comparison of Intranasal Dexmedetomidine with Intranasal Clonidine as a Premedication in Surgery

Sidhu, Gurkaran Kaur; Jindal, Swati; Kaur, Gurinder; Singh, Gurpreet; Gupta, Kewal Krishan; Aggarwal, Shobha

doi:10.1007/s12098-016-2149-4

Cited by 18 publications

(8 citation statements)

References 31 publications

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“…This difference in result may be due to the fact that in their study midazolam was only compared to placebo resulting in bias towards midazolam. Similarly, Sidhu GK et al, in their study found satisfactory sedation and anxiolysis in 60 % and 25.7% of the children receiving 3 μg/kg of intranasal clonidine, respectively (Sidhu, G. K. et al, 2016).…”

Section: Resultsmentioning

confidence: 74%

Comparative Evaluation of Midazolam and Clonidine as Premedicants in Children Undergoing Elective Orodental Surgeries: A Randomized, Double Blind Trial

Gupta¹,

Gupta²,

Jamwal³

et al. 2022

IARJACC

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Background: Preoperative anxiety is common in children that can have impact on induction, emergence from anesthesia and/ or on the psychological state of the child. Intranasal route offers an advantage of rapid and virtually complete absorption due to high mucosal vascularity. Objective: The present study aimed to compare efficacy of midazolam with clonidine for intranasal premedication in pediatric patients scheduled to undergo elective orodental surgeries. Methods: One hundred and five children of either sex, aged between 3-7 years belonging to American Society of Anesthesiologists ASA) physical status 1 and 2 undergoing elective orodental surgeries were randomly assigned to three study groups. Group 1 n=35) received 0.5 ml of 0.2 mg/kg midazolam, Group 2 n=35) received 0.5 ml 1µ/kg clonidine and Group 3 n=35) received 0.5 ml of normal saline in each nostril 40 minutes before inducing anesthesia. Heart rate, mean arterial blood pressure, SpO2, degree of sedation was measured every 10 minutes till 30 minutes according to the 5- point sedation scale. The reaction to intravenous i.v.) cannulation was noted according to 4-point scale and child’s face mask acceptance was noted according to 5-point scale. After induction of anesthesia, vitals were noted every 10 minutes, intraoperatively. Postoperatively, level of sedation was assessed every 10 minutes for one hour using 3- point scale. Results: The difference in sedation score between group 1 and 2 was insignificant at 10 minutes but highly significant at 20 min, 30 min and 40 minutes with more sedation in clonidine group. Heart rate and blood pressure were lower in clonidine group. Children in group 2 had better reaction to i.v. cannulation and mask acceptance scores compared with group 1. Postoperative sedation was highest in clonidine group and these children had better wake up scores than midazolam. Conclusion: Compared to midazolam, intranasal clonidine provides higher sedation level, better mask acceptance and better response to intravenous cannulation.

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Section: Resultsmentioning

confidence: 74%

Comparative Evaluation of Midazolam and Clonidine as Premedicants in Children Undergoing Elective Orodental Surgeries: A Randomized, Double Blind Trial

Gupta¹,

Gupta²,

Jamwal³

et al. 2022

IARJACC

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“…Among these, full text could not be found for one article, and after reading the remaining 71 articles, 51 articles that did not meet the inclusion criteria were excluded. Finally, 20 RCTs were included in this network metaanalysis [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. The flowchart is shown in Fig.…”

Section: Systemic Retrieval Resultsmentioning

confidence: 99%

Effects of different doses of intranasal dexmedetomidine on related complications and parents’ satisfaction in anesthetized children: a systematic review

Hu,

Wang,

Sun

2024

BMC Pediatr

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Background Agitation/delirium is commonly seen in children after anesthesia, and a proper dose of dexmedetomidine can prevent this complication. This study aimed to investigate the effects of different doses of Dexmedetomidine (DEX) on agitation/delirium and other complications in anesthetized children, providing clinical evidence for dose recommendations of DEX. Methods This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search was conducted in the Cochrane Library, PubMed, Web of Science, and EMBASE. Two independent researchers performed literature screening, data extraction, and assessed the methodological quality. Data analysis was conducted using R and STATA 16.0. Results In the final analysis, 20 randomized controlled trials (RCTs) involving 2521 children were included. The results showed that in comparison to normal saline, 1 µg/kg, 1.5 µg/kg, and 2 µg/kg intranasal DEX significantly reduced the incidence of post-anesthetic emergence agitation in children with the most effective dose being 2 µg/kg (SUCRA = 0.91). Compared with normal saline, 1 µg/kg, 1.5 µg/kg, and 2 µg/kg intranasal DEX reduced patient’s need for postoperative analgesia, with the most effective dose being 1.5 µg/kg (SUCRA = 0.78). However, 1 µg/kg DEX performed the best in reducing Pediatric Anaesthesia Emergence Delirium (PAED) Scale score (SUCRA = 0.88). Conclusion Compared with normal saline, intranasal administration of 2 µg/kg DEX and 1.5 µg/kg DEX are the optimal doses to reduce the incidence of agitation and the need for postoperative pain relief in children under general anesthesia. Given effectiveness and safety, intranasal use of 1 µg/kg DEX appears to be the most effective dosage for anesthetized children.

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“…Oral routes have been extensively examined [ 24 ], but data on IN are scant. IN delivery is a simple, noninvasive approach with great bioavailability [ 25 ]. Drug delivery and development are the most important translational research contributions to human health and well-being [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Premedication with intranasal versus intravenous dexmedetomidine for hypotensive anesthesia during functional endoscopic sinus surgery in adults: A randomized triple-blind trial

Kohaf,

Harby,

Abd-Ellatief

et al. 2024

Heliyon

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Comparison of Intranasal Dexmedetomidine with Intranasal Clonidine as a Premedication in Surgery

Cited by 18 publications

References 31 publications

Comparative Evaluation of Midazolam and Clonidine as Premedicants in Children Undergoing Elective Orodental Surgeries: A Randomized, Double Blind Trial

Comparative Evaluation of Midazolam and Clonidine as Premedicants in Children Undergoing Elective Orodental Surgeries: A Randomized, Double Blind Trial

Effects of different doses of intranasal dexmedetomidine on related complications and parents’ satisfaction in anesthetized children: a systematic review

Premedication with intranasal versus intravenous dexmedetomidine for hypotensive anesthesia during functional endoscopic sinus surgery in adults: A randomized triple-blind trial

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