Efficacy of Intranasal Dexmedetomidine Premedication as an Adjunct on Intubation Process in Paediatric Patients: A...

To evaluate the effect of a single intranasal dose of dexmedetomidine (2 μg kg^-1) on intubation efficacy, mask acceptance, sedation quality, intubation duration, and intraoperative fentanyl consumption in children undergoing elective surgery.

A randomized, double-blind, placebo-controlled trial was conducted in 40 American Society of Anaesthesiologists I-II children aged 1-6 years who were scheduled for elective surgery. Participants were randomized to receive either dexmedetomidine (n = 20) or 0.9% sodium chloride placebo (n = 20). All patients received intravenous midazolam as a routine premedication. Primary outcomes were mean arterial pressure (MAP) and heart rate (HR), measured at baseline and post-intubation; these were compared to assess intubation efficacy. Secondary outcomes included mask acceptance, sedation quality, intubation time, and total fentanyl consumption. Data were analyzed using the independent-samples t-test or the Mann-Whitney U test (P <0.05).

Dexmedetomidine maintained MAP (1.34±19.59%) versus a significant rise with placebo (21.95±26.36%; P=0.008) and limited HR increase (1.6% vs. 22.2%; P <0.001).Mask acceptance and adequate sedation were significantly higher (P <0.001). Intubation duration did not differ (median 39 seconds vs. 44 seconds; P=0.267). Fentanyl consumption was significantly lower (1.10 vs. 2.15 μg kg^-1; P <0.001).

A single intranasal dose of dexmedetomidine provides superior intubation efficacy, improves mask acceptance and sedation quality, and yields a significant opioid-sparing effect.