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The Sedative Effects of Inhaled Nebulized Dexmedetomidine on Children: A Systematic Review and Meta-Analysis

Jun Lin1,2, Chujun Wu1, Dizhou Zhao3

  • 1Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Frontiers in Pediatrics
|June 7, 2022
PubMed

Insights

Inhaled nebulized dexmedetomidine offers comparable sedation for pediatric procedures. This method effectively reduces emergence agitation and postoperative nausea and vomiting in children undergoing medical exams or surgery.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Medical Sedation

Background:

  • Pediatric patients often require sedation for medical examinations and surgery due to uncooperative behavior.
  • Assessing the safety and efficacy of inhaled nebulized dexmedetomidine is crucial for improving preoperative sedation in children.

Approach:

  • A systematic literature search was conducted across PubMed, Web of Science, Embase, and Cochrane Library.
  • Included randomized controlled trials (RCTs) evaluating intranasal dexmedetomidine (spray or mucosal atomization) in pediatric patients undergoing examinations or elective surgery.
  • Analyzed sedation efficiency, separation success, and mask acceptability.

Key Points:

  • Inhaled nebulized dexmedetomidine demonstrated similar sedation satisfaction and separation success compared to other treatments.
  • Combination therapy with nebulized dexmedetomidine and ketamine significantly improved sedation and separation satisfaction.
  • Nebulized dexmedetomidine notably reduced the incidence of nausea, vomiting, and emergence agitation.
  • No significant hypotension or arrhythmia requiring intervention was reported.

Conclusions:

  • Inhaled nebulized dexmedetomidine is a safe and effective option for pediatric preoperative sedation, offering equivalent satisfaction to other methods.
  • This approach significantly lowers the incidence of emergence agitation and postoperative nausea and vomiting.
  • Nebulized dexmedetomidine, particularly in combination with ketamine, enhances sedation quality and patient comfort during procedures.
Abstract

Keywords:
childrendexmedetomidinemucosal atomization devicesedationspraysurgery

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