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Effect of different routes of administration on early cognitive function following inguinal hernia repair
Jianping Huang1, Bing Deng2, Jing Shuai3
1Department of Anesthesiology, Ji'an Maternal and Child Health Care Hospital Ji'an 343000, Jiangxi Province, China.
Insights
Intranasal dexmedetomidine in pediatric hernia repair promotes better sedation and less postoperative agitation compared to intravenous administration. This route also significantly reduces the incidence of early cognitive dysfunction in children.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Dexmedetomidine is commonly used for sedation and anesthesia in pediatric surgery.
- Different administration routes may impact its efficacy and side effect profile.
- Early cognitive function is a critical outcome measure in pediatric anesthesia.
Purpose of the Study:
- To compare the effects of intranasal versus intravenous dexmedetomidine on early cognitive function after pediatric inguinal hernia repair.
- To evaluate hemodynamic stability, sedation levels, and agitation during emergence.
Main Methods:
- 83 pediatric patients undergoing inguinal hernia repair were randomized into two groups.
- Observation group (OG) received intranasal dexmedetomidine (2 μg/kg).
- Control group (CNG) received intravenous dexmedetomidine (0.5 μg/kg).
Main Results:
- Both groups showed stable hemodynamics and oxygen saturation.
- Intranasal dexmedetomidine resulted in lower emergence agitation (4.76% vs 21.95%) and reduced postoperative cognitive dysfunction (4.76% vs 21.95%) at 3 days.
- The intranasal group exhibited better sedation scores and higher cognitive, language, and motor scores post-surgery.
Conclusions:
- Both intranasal and intravenous dexmedetomidine are safe and effective for pediatric inguinal hernia repair, ensuring rapid awakening.
- Intranasal administration offers superior sedation, reduced postoperative agitation, and a lower incidence of cognitive dysfunction.
- Intranasal dexmedetomidine is a promising alternative for improved pediatric postoperative recovery.
Purpose:
To analyze the effects of different routes of dexmedetomidine administration on early cognitive function following inguinal hernia repair.
Methods:
A total of 83 patients with pediatric inguinal hernias admitted to our hospital from January 2018 to October 2020 were divided into control group (CNG, n = 41) and observation group (OG, n = 42) by random number table. The OG was given 2 μg/kg of dexmedetomidine hydrochloride by intranasal administration, and the CNG was treated with 0.5 μg/kg of dexmedetomidine hydrochloride via intravenous (IV) infusion pump. The hemodynamics, condition of anesthesia, awakening, and safety were compared between the two groups.
Results:
Systolic blood pressure and oxygen saturation levels at T1 and T2 in the OG were not different from those in the CNG (P > 0.05), and heart rates in the OG were all higher than those in the CNG (P < 0.05). The incidence of emergence agitation during awakening was 4.76% in the OG, which was lower than 21.95% compared with the CNG (P < 0.05). Ramsay sedation scores at 15 and 30 min after awakening in the OG were higher than those in the CNG, and PAED scores in the OG were lower than those in the CNG (P < 0.05). Cognitive, language, and motor scores in the OG were higher than those in the CNG at 3 days after surgery (P < 0.05), and the incidence of cognitive dysfunction was 4.76% in the OG at 3 days after surgery, which was lower compared with 21.95% in the CNG (P < 0.05).
Conclusion:
Application of dexmedetomidine hydrochloride by intranasal administration or intravenous infusion before induction can ensure rapid postoperative awakening of the children without causing significant fluctuations in blood pressure and oxygen saturation, and both methods have a high safety profile. However, intranasal administration results in more satisfactory sedation, less postoperative agitation upon awakening, and reduces postoperative cognitive dysfunction.
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