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Håkansson I, Ahlander BM, Höök A, Kihlberg J. Retrospective comparison between MRI examinations during radiographer-administered intranasal sedation or general anesthesia. Radiography (Lond) 2024; 30:296-300. [PMID: 38071937 DOI: 10.1016/j.radi.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/20/2023] [Accepted: 11/26/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION In order for young children to be able to undergo a Magnetic Resonance Imaging (MRI) examination, general anesthesia is often required. The aim of this study was to compare the image quality, times, and costs of the examinations of infant brains performed with MRI either during sedation with dexmedetomidine administered by radiographers or anesthesia with propofol administered by anesthesia staff. METHODS This study was a quantitative retrospective study of 27 consecutive standard brain examinations performed under sedation or anesthesia, involving 15 children under sedation and 12 under anesthesia. The age of the children was from 0.5 to five years old. The image quality was evaluated by three radiologists experienced in pediatric MRI examinations. Information such as examination time and the expense of the examination was also collected. RESULTS There was no statistically significant difference in the general image quality, but one image series was assessed to have significantly better image quality under sedation than under anesthesia, but all images had very high quality. However, it emerged that children under anesthesia were at the hospital on average 55 min longer and the scanner room was occupied 20 min longer on average. The anesthesia examinations were three times more expensive. CONCLUSION This study demonstrated equivalent image quality between sedation and anesthesia. In addition, sedation was less time-consuming and had a lower price, partly because no extra anesthetic staff were required. The use of intranasal sedation offers a possibility to expand the competence area for radiographers. IMPLICATIONS FOR PRACTICE If radiographers learn to perform intranasal sedation, examinations can be performed in less time, at a third of the staff costs while maintaining image quality.
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Affiliation(s)
- I Håkansson
- Ryhov County Hospital, Department of Radiology, Jönköping, Sweden
| | - B-M Ahlander
- Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Gjuterigatan 5, SE-553 18, Jönköping, Sweden
| | - A Höök
- Department of Anaesthesiology and Intensive Care in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - J Kihlberg
- Department of Radiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
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Baptista P, Moffa A, Giorgi L, Casale M. Randomized Clinical Trial to Evaluate the Efficacy and Tolerability of Nebulized Hyaluronic Acid and Xylitol Based Solution after Septoturbinoplasty. J Pers Med 2023; 13:1160. [PMID: 37511773 PMCID: PMC10381544 DOI: 10.3390/jpm13071160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Septoplasty and turbinate surgery are among the most frequent surgical procedures to improve nasal obstruction and quality of life. These procedures usually imply the presence of congestion, secretions, and crusting related to the movement of the instruments during surgery. However, the use of nasal lavage may reduce this situation. The addition of Hyaluronic acid or Xylitol offers advantages in these washes. This study was a randomized, double-blind, controlled trial. All patients underwent endoscopic septoplasty with inferior turbinate submucosal resection without posterior nasal packing. SNOT-22, main VAS, NOSE, Modified Lund-Kennedy endoscopic scale, number of crusts and adhesions were quantified before and on the day of the surgery, visit three (seven days), visit four (fourteen days), and visit five (twenty-eight days). Forty-seven patients completed the study, divided into a standard saline arm (group 1, 22 patients) and normal saline plus HA and Xylitol arm (group 2, 27 patients). Both treatment groups improved their quality of life and objective parameters during the four weeks of the study. All patients tolerated the nasal irrigations well, and none discontinued the treatments. The study concludes that nasal washes of Aluneb Isotónico® offer several benefits to patients as a protective and preventative agent.
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Affiliation(s)
- Peter Baptista
- Department of Otorhinolaryngology, Clinica Universidad de Navarra, 31008 Pamplona, Navarra, Spain
- ENT Department, Al Zahra Private Hospital Dubai, Dubai 23614, United Arab Emirates
| | - Antonio Moffa
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Lucrezia Giorgi
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Manuele Casale
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- School of Medicine, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
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Lu Y, Peng C, Xie L, Wu Y, Gu L, Li S. Nasal drip of dexmedetomidine for optimal sedation during PICC insertion in pediatric burn care. Medicine (Baltimore) 2023; 102:e32831. [PMID: 36820563 PMCID: PMC9907929 DOI: 10.1097/md.0000000000032831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND For peripherally inserted central catheter (PICC) inserting, tranquil cooperation of children for an extended period is often required. Therefore, sedation is routinely induced clinically prior to PICC inserting. Chloral hydrate is a commonly used sedative for children. However, its clinical acceptance has remained low. And the sedation effect is non-satisfactory. Previous studies have confirmed the safety and effectiveness of intravenous/oral dosing or nasal dripping for sedation during the examinations of electrocardiography and computed tomography. Yet few studies have assessed the sedating efficacy of dexmedetomidine nasal drops for PICC inserting. METHODS From a cohort of 40 hospitalized patients scheduled for PICC inserting, 15 children employing a novel sedative mode of dexmedetomidine nasal drops at a dose of 2 ug/kg were assigned into group A while group B included another 25 children sedated routinely via an enema of 10% chloral hydrate at a dose of 0.5 mL/kg. The Ramsay's scoring criteria were utilized for assessing the status of sedation. Two groups were observed with regards to success rate of sedation, onset time of sedation and occurrences of adverse reactions. RESULTS Statistical inter-group differences existed in success rate and onset time of sedation. The success rate of group A was higher than that of group B (93.3% vs 64.0%, X2 = 4.302, P = .038 < 0.05). Group A had a faster onset of sedation than group B (14.86 ± 2.57 vs 19.06 ± 3.40 minutes, t = 3.781, P = .001 < 0.05). No inter-group difference of statistical significance existed in occurrence of adverse reactions (P = 1.000 > 0.05). Logistic regression analysis showed that the success rate of sedation in group A was higher than that in group B, and the difference was statistically significant (P = .036 < 0.05). CONCLUSIONS For sedating burn children, nasal dripping of dexmedetomidine is both safe and effective during PICC inserting. Without any obvious adverse reaction, it may relieve sufferings and enhance acceptance.
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Affiliation(s)
- Yanxu Lu
- Xiangya Stomatological Hospital & School of Stomatology, Central South University, Changsha, Hunan, China
| | - Cheng Peng
- Xiangya School of Nursing, Central South University, Changsha Hunan, China
| | - Li Xie
- Department of Burn & Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- * Correspondence: Li Xie, Nurse-in-Charge, Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University; Department of Burn & Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P. R. China (e-mail: )
| | - Ying Wu
- Department of Burn & Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lifang Gu
- Department of Burn & Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sha Li
- Department of Burn & Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Yamagiwa Y, Kurata M, Satoh H. Histological Features of the Nasal Passage in Juvenile Japanese White Rabbits. Toxicol Pathol 2022; 50:218-231. [PMID: 34989261 DOI: 10.1177/01926233211068797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rabbits are sometimes used for intranasal toxicology studies. We investigated the postnatal development of the nasal passage in juvenile Japanese white rabbits from just after birth to 6-week-old to provide information for conducting intranasal toxicological evaluation using juvenile animals. On postnatal day (PND) 1, the nasal passage consisted of the septum with mostly cartilaginous nasal wall and turbinates. The lining squamous, transitional, respiratory, and olfactory epithelia were already distributed similar to adults and were still underdeveloped. The nasal passage gradually expanded with age, as did the nasal wall, including the turbinates formed by endochondral ossification. The maxilloturbinate elongated, during which it branched complexly. The respiratory epithelium takes the form of columnar epithelium together with a reduction in goblet cells. In addition, the olfactory epithelium had clear cytoplasm in the ethmoturbinate, the olfactory nerve bundles thickened, and Bowman's gland acini increased in size and number. Other tissues, including the vomeronasal organ, nasal-associated lymphoid tissue, and nasolacrimal duct, also developed histologically with age. This investigation characterized the postnatal histological development of the nasal passage in Japanese white rabbits, providing basic knowledge regarding the histological examination and rationale for appropriate study design of intranasal toxicology studies in juvenile rabbits.
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Affiliation(s)
- Yoshinori Yamagiwa
- Senju Pharmaceutical Co., Ltd., Kobe, Japan.,Graduate School of Veterinary Sciences, Iwate University, Morioka, Japan
| | | | - Hiroshi Satoh
- Graduate School of Veterinary Sciences, Iwate University, Morioka, Japan
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Banno S, Baba T, Tanabe H, Homma Y, Ochi H, Watari T, Kobayashi H, Kaneko K. Use of traction table did not increase complications in total hip arthroplasty through direct anterior approach performed by novice surgeon. J Orthop Surg (Hong Kong) 2021; 28:2309499020923093. [PMID: 32583712 DOI: 10.1177/2309499020923093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate the surgical outcomes of total hip arthroplasty (THA) through direct anterior approach (DAA) performed by beginners by comparing the outcomes after the introduction of DAA-THA between using a normal operating table and a traction table. METHODS The total subjects were 200 patients, there were 120 cases from the introduction of three surgeons using a normal table and 80 cases from two surgeons using a traction table. The surgical procedure was standardized, and a surgeon skilled in DAA entered the operating room and instructed the novice surgeons of DAA in all cases. RESULTS The mean operative time was no significant difference between the two groups (p = 0.093). The difference in slope of the operative time was no significant difference between the two groups (p value = 0.089). The mean fluoroscopy time and the mean blood loss were significant difference between the two groups (p < 0.05). The difference in slope of the fluoroscopy time and blood loss were significant difference between the two groups (p < 0.05). There were no intraoperative complications and no reoperations for any reason. CONCLUSIONS At the facility with a surgeon skilled in DAA, the use of a traction table in DAA did not increase the complication rate compared with the use of a normal operating table when the exclusion criteria for DAA were set and surgery was performed using intraoperative fluoroscopy under supervision by a skilled surgeon.
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Affiliation(s)
- Sammy Banno
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomonori Baba
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroki Tanabe
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Yasuhiro Homma
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Hironori Ochi
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Taiji Watari
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Hideo Kobayashi
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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Wasfy SF, Hassan RM, Hashim RM. Effectiveness and safety of Ketamine and Midazolam mixture for procedural sedation in children with mental disabilities: A randomized study of intranasal versus intramuscular route. EGYPTIAN JOURNAL OF ANAESTHESIA 2020. [DOI: 10.1080/11101849.2020.1727669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Sanaa Farag Wasfy
- Anesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rasha Mahmoud Hassan
- Anesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Reham Mustafa Hashim
- Anesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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McNair C, Graydon B, Taddio A. A cohort study of intranasal fentanyl for procedural pain management in neonates. Paediatr Child Health 2019; 23:e170-e175. [PMID: 30842699 DOI: 10.1093/pch/pxy060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objectives The objective of this cohort study was to document experience with intranasal (IN) fentanyl analgesia for procedural pain management in neonates in a surgical neonatal intensive care unit. A consecutive sample of 23 neonates without intravenous access treated with IN fentanyl was included. Methods Data were extracted from medical charts, including infant characteristics, indication for IN fentanyl, dose, physiologic parameters (heart rate, respiratory rate, oxygen saturation, blood pressure) and pain scores. Physiologic parameters were recorded for 6 hours before and after IN fentanyl. Pain scores were recorded during and after the procedure using the Premature Infant Pain Profile (PIPP). Results The mean (SD) postmenstrual age of included infants was 31.8 weeks (4.1), and 52% were receiving some form of ventilator support. The mean dose of IN fentanyl was 1.3 mcg/kg (0.4) and most common indication was analgesia for peripheral insertion of central catheter. There were six cases of cardiorespiratory depression as defined, however, clinical factors could account for all of them. The mean PIPP score during and after the procedure was 4.3 (1.8) and 3.6 (1.5), respectively (scores <6 indicate no pain). Conclusions This small study provides some preliminary evidence of the benefits and risks of IN fentanyl in this population.
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Affiliation(s)
- Carol McNair
- NICU, SickKids, Toronto, Ontario.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
| | | | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.,Child Health Evaluative Sciences (CHES), SickKids, Toronto, Ontario
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Sedation effects of intranasal dexmedetomidine delivered as sprays versus drops on pediatric response to venous cannulation. Am J Emerg Med 2017; 35:1126-1130. [DOI: 10.1016/j.ajem.2017.03.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 03/13/2017] [Indexed: 11/23/2022] Open
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Kim HJ, Shin WJ, Park S, Ahn HS, Oh JH. The sedative effects of the intranasal administration of dexmedetomidine in children undergoing surgeries compared to other sedation methods: A systematic review and meta-analysis. J Clin Anesth 2017; 38:33-39. [DOI: 10.1016/j.jclinane.2017.01.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 12/30/2016] [Accepted: 01/09/2017] [Indexed: 11/24/2022]
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Efficacy of Intranasal Dexmedetomidine for Conscious Sedation in Patients Undergoing Surgical Removal of Impacted Third Molar: A Double-Blind Split Mouth Study. J Maxillofac Oral Surg 2016; 15:512-516. [PMID: 27833345 DOI: 10.1007/s12663-016-0889-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/17/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND This study was conducted to evaluate the utility and effectiveness of Intranasal Dexmedetomidine on Sedation status and pain experience of the patients undergoing surgical extraction of impacted third molar. MATERIALS AND METHODS In this double-blind, split mouth study, in 15 patients, evaluations pertaining to classes of third molar impaction was done. Each patient was randomly assigned to receive either intranasal normal saline (placebo group) or intranasal 1.5 µg/kg atomized Dexmedetomidine during the first session. The other regimen was used during the second session. Study was conducted for over a period of 120 min and data for sedation and pain was collected at an interval of 30 min. The collected data was then compared between the two groups within the same patient. Sedation status was assessed by a blinded observer with a modified Observer's Assessment of Alertness/Sedation (OAA/S) 13 scale (Annexure- B). Pain experience was evaluated by Visual Analog Scale (VAS) (Annexure-B). Clinical evaluation for sedation and pain was done by a blinded observer at 30, 60, 90, and 120 min after administration of the intranasal solution. The values were then tabulated, and compared between two visits. RESULTS The mean values of OAA score of Dexmedetomidine group were significantly higher as compared to Placebo group with a 'p' value of 0.000. And the mean values of Pain score of Dexmedetomidine group were significantly lower as compared to Placebo group with a 'p' value 0.009. CONCLUSION The results of this study clearly indicated that: Intranasally administered Dexmedetomidine was significantly useful and effective to achieve optimal sedation and analgesia during third molar surgery.
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Zanaty OM, El Metainy SA. A Comparative Evaluation of Nebulized Dexmedetomidine, Nebulized Ketamine, and Their Combination as Premedication for Outpatient Pediatric Dental Surgery. Anesth Analg 2015; 121:167-171. [DOI: 10.1213/ane.0000000000000728] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
The case of a 2-month-old boy with previously diagnosed tetralogy of Fallot who was brought to the emergency department with a hypercyanotic spell is described. Because partly of the difficulty of intravenous placement, especially in an infant crying with marked hypernea and deeply cyanotic, intranasal midazolam was administered. Before 3 minutes of hypernea terminated increasing the oxygen saturation successfully and intravenous line was easily placed with the baby remaining in calm. Sedation is an important step in the management of patients with cyanotic spells. Intranasal midazolam offers an alternative use as an initial method of calming the child that was effective in a patient with a severe cyanotic spell because of tetralogy of Fallot in the emergency department.
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Sheta SA, Al-Sarheed MA, Abdelhalim AA. Intranasal dexmedetomidine vs midazolam for premedication in children undergoing complete dental rehabilitation: a double-blinded randomized controlled trial. Paediatr Anaesth 2014; 24:181-9. [PMID: 24237879 DOI: 10.1111/pan.12287] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND This prospective, randomized, double-blind study was designed to evaluate the use of intranasally administered dexmedetomidine vs intranasal midazolam as a premedication in children undergoing complete dental rehabilitation. METHODS Seventy-two children of American Society of Anesthesiology classification (ASA) physical status (I & II), aged 3-6 years, were randomly assigned to one of two equal groups. Group M received intranasal midazolam (0.2 mg·kg(-1)), and group D received intranasal dexmedetomidine (1 μg·kg(-1)). The patients' sedation status, mask acceptance, and hemodynamic parameters were recorded by an observer until anesthesia induction. Recovery conditions, postoperative pain, and postoperative agitation were also recorded. RESULTS The median onset of sedation was significantly shorter in group M 15 (10-25) min than in group D 25 (20-40) min (P = 0.001). Compared with the children in group M, those in group D were significantly more sedated when they were separated from their parents (77.8% vs 44.4%, respectively) (P = 0.002). Satisfactory compliance with mask application was 58.3% in group M vs 80.6% in group D (P = 0.035). The incidences of postoperative agitation and shivering were significantly lower in Group D compared with group M. Thirteen children (36.1%) in group M, showed signs of nasal irritation with teary eyes, and none of these signs was seen in the children in group D (P = 0.000). There were no incidences of bradycardia, hypotension, in either of the groups during study observation. CONCLUSION Intranasal dexmedetomidine (1 μg·kg(-1)) is an effective and safe alternative for premedication in children; it resulted in superior sedation in comparison to 0.2 mg·kg(-1) intranasal midazolam. However, it has relatively prolonged onset of action.
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Affiliation(s)
- Saad A Sheta
- Division of Anesthesiology, Department of Oral maxillofacial Surgery & Anesthesia, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Comparison between intranasal dexmedetomidine and intranasal ketamine as premedication for procedural sedation in children undergoing MRI: a double-blind, randomized, placebo-controlled trial. J Anesth 2013; 28:12-8. [PMID: 23800984 DOI: 10.1007/s00540-013-1657-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 06/12/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Providing anesthesia to children undergoing MRI is challenging. Adequate premedication, administered noninvasively, would make the process smoother. In this study, we compare the efficacy of intranasal dexmedetomidine (DXM) with the intranasal administration of ketamine for procedural sedation in children undergoing MRI. METHODS We studied 150 children, between 1 and 10 years of age, divided randomly into three groups (DXM, K, and S). For blinding, every child received the intranasal drugs twice; syringe S1, 60 min before, and syringe S2, 30 min before intravenous (IV) cannulation. For children in group DXM, S1 contained DXM (1 μg/kg) and S2 was plain saline. Children in group K received saline in S1 and ketamine (5 mg/kg) in S2 whereas children in group S received saline in both S1 and S2. The child's response to drug administration, ease of IV cannulation, the satisfaction of the anesthesiologist and child's parents with the premedication, and the total propofol dose required for the satisfactory conduct of the procedure were compared. We also compared the time to awakening and discharge of the child as well as the occurrence of any side effects with these drugs. RESULTS Both DXM and ketamine were equally effective as premedication in these patients. Most of the children accepted the intranasal drugs with minimal discomfort; 90.4 % of the anesthesiologists in the DXM group and 82.7 % in the ketamine group were satisfied with the conditions for IV cannulation whereas only 21.3 % were satisfied in the saline group. The total dose of propofol used was less in the study groups. Furthermore, children in group DXM and group K had earlier awakening and discharge than those in group S. CONCLUSION DXM and ketamine were equally effective, by the intranasal route, as premedication in children undergoing MRI.
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