title: Intranasal dexmedetomidine premedication reduces the minimum alveolar concentration of sevoflurane for tracheal intubation in children: a randomized trial.
abstract: OBJECTIVE
  To determine the effects of dexmedetomidine premedication on the minimum alveolar concentration of sevoflurane for tracheal intubation (MACTI) in children.
  
  
  METHODS
  Prospective, randomized, clinical comparison study.
  
  
  METHODS
  Operating room of an academic hospital.
  
  
  METHODS
  90 pediatric, ASA physical status 1 patients, aged 3 to 7 years, scheduled for minor elective surgery.
  
  
  METHODS
  Patients were randomized to three groups to receive placebo, dexmedetomidine 1 μg/kg, or dexmedetomidine 2 μg/kg approximately 60 minutes before anesthesia. Anesthesia was induced with sevoflurane. Each concentration of sevoflurane for which a tracheal intubation was attempted was predetermined according to modification of the Dixon's up-and-down method, with 0.25% as a step size and held constant for at least 15 minutes before tracheal intubation. All responses ("movement" or "no movement") to tracheal intubation were assessed.
  
  
  RESULTS
  The MACTI of sevoflurane was 2.82% ± 0.17% in the control group, 2.26% ± 0.18% in the 1 μg/kg dexmedetomidine group, and 1.83% ± 0.16% in the 2 μg/kg dexmedetomidine group. Dexmedetomidine premedication (1 and 2 μg/kg) decreased the MACTI of sevoflurane by 20% and 35%, respectively. There were no clinically significant episodes of hypotension or bradycardia in any patients.
  
  
  CONCLUSIONS
  Intranasal dexmedetomidine premedication produces a dose-dependent decrease in the concentration of sevoflurane needed for tracheal intubation in children.
authors.affiliation: Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Anesthesiology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, China.
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Anesthesiology, The People's Hospital of Fujian Province, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Qian
authors.affiliation: Department of Anesthesiology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, China.
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: sculiujin@126.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Liu
mesh_terms: D000281:Administration, Intranasal; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000493:pharmacokinetics; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology*; D007442:Intubation, Intratracheal / Q000379:methods; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage / Q000493:pharmacokinetics*; D011292:Premedication / Q000379:methods; D011446:Prospective Studies; D011650:Pulmonary Alveoli / Q000378:metabolism*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D020927:Dexmedetomidine
keywords: Alpha2-adrenoceptor agonist; Anesthetics; Dexmedetomidine; Drug administration; Minimum alveolar concentration; Potency; Premedication; Sevoflurane; Volatile; intranasal