title: A randomised study of intranasal dexmedetomidine and oral ketamine for premedication in children.
abstract: We studied the effects of intranasal dexmedetomidine combined with oral ketamine for premedication in children. One hundred and sixty children aged between 2 and 6 years were randomly allocated to one of four groups: 1 μg.kg(-1) intranasal dexmedetomidine with 3 mg.kg(-1) oral ketamine (Group 1); 1 μg.kg(-1) intranasal dexmedetomidine with 5 mg.kg(-1) oral ketamine (Group 2); 2 μg.kg(-1) intranasal dexmedetomidine with 3 mg.kg(-1) oral ketamine (Group 3); and 2 μg.kg(-1) intranasal dexmedetomidine with 5 mg.kg(-1) oral ketamine (Group 4). Sedation levels 10, 20 and 30 min after premedication were evaluated using a 5-point sedation scale. A 4-point emotional state score was used to evaluate patients when they were separated from their parents and their response to intravenous cannulation or facemask application. Approximately 90% of patients readily accepted premedication and onset times of acceptable sedation were similar in all four groups. Patients in Group 4 were significantly more sedated than those in Group 1 after 30 min (p = 0.036). A significantly higher proportion of patients in Group 3 (84%) and Group 4 (87%) accepted intravenous cannulation compared with those in Group 1 (40%) and Group 2 (54%) (p = 0.001). We conclude that the administration of 2 μg.kg(-1) intranasal dexmedetomidine and 3 mg.kg(-1) oral ketamine was the optimal combination, with children being easily separated from their parent, accepting intravenous cannulation and without causing excessive side-effects or postoperative complications.
authors.affiliation: Department of Anesthesiology, EENT Hospital, Shanghai, China.
authors.forename: J-E
authors.initials: JE
authors.lastname: Jia
authors.forename: J-Y
authors.initials: JY
authors.lastname: Chen
authors.forename: X
authors.initials: X
authors.lastname: Hu
authors.forename: W-X
authors.initials: WX
authors.lastname: Li
mesh_terms: D000281:Administration, Intranasal / Q000379:methods; D000284:Administration, Oral; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007649:Ketamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011229:Preanesthetic Medication / Q000379:methods*; D013315:Stress, Psychological / Q000517:prevention & control*
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D007649:Ketamine