title: Intranasal Dexmedetomidine as a Sedative Premedication for Patients Undergoing Suspension Laryngoscopy: A Randomized Double-Blind Study.
abstract: Intranasal dexmedetomidine, a well-tolerated and convenient treatment option, has been shown to induce a favorable perioperative anxiolysis in children. We investigate intranasal dexmedetomidine as a sedative premedication for anesthesia recovery in an adult population.
  
  
  
  A prospective randomized controlled trial; 81 adult patients scheduled for elective suspension laryngoscopy received intranasal dexmedetomidine (1 μg∙kg-1) or a placebo 45-60 min before anesthetic induction. Extubation time was used as the primary outcome measure. Secondary variables included the levels of sedation (Observer's Assessment of Alertness/Sedation scale, OAA/S) and anxiety (4-point anxiety score), anesthetic and analgesic requirements, hemodynamic fluctuations, and anesthesia recovery as well as side effects.
  
  
  
  The levels of sedation and anxiety differed significantly between the two groups at anesthesia pre-induction (p < 0.001 and = 0.001, respectively). Repeated-measure general linear model determined no significant interaction effect between group and time on the targeted concentration of propofol (F = 1.635, p = 0.200), but a significant main effect of group existed (F = 6.880, p = 0.010). A moderate but significant decrease in the heart rate was recorded in the dexmedetomidine group at pre-induction. Episodes of tachycardia and hypertension after tracheal intubation and extubation were more frequent in the placebo group.
  
  
  
  Intranasal dexmedetomidine as a sedative premedication induced a favorable perioperative anxiolysis without prolongation in anesthesia recovery; the hemodynamic effect was modest.
  
  
  
  ClinicalTrials.gov NCT 02108171.
authors.affiliation: Department of Anesthesiology, First Municipal People's Hospital of Guangzhou, an Affiliate Hospital of Guangzhou Medical College, Guangzhou, China.
authors.forename: Chengxiang
authors.initials: C
authors.lastname: Lu
authors.affiliation: University of Pittsburgh Medical Centre, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Zhang
authors.affiliation: Department of Ophthalmology, First Municipal People's Hospital of Guangzhou, an Affiliate Hospital of Guangzhou Medical College, Guangzhou, China.
authors.forename: Yuehong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, First Municipal People's Hospital of Guangzhou, an Affiliate Hospital of Guangzhou Medical College, Guangzhou, China.
authors.forename: Yanlu
authors.initials: Y
authors.lastname: Ying
authors.affiliation: Department of Medical Infomation, First Municipal People's Hospital of Guangzhou, an Affiliate Hospital of Guangzhou Medical College, Guangzhou, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, First Municipal People's Hospital of Guangzhou, an Affiliate Hospital of Guangzhou Medical College, Guangzhou, China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology, First Municipal People's Hospital of Guangzhou, an Affiliate Hospital of Guangzhou Medical College, Guangzhou, China.
authors.forename: Xiangcai
authors.initials: X
authors.lastname: Ruan
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000758:Anesthesia; D000777:Anesthetics / Q000008:administration & dosage; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007828:Laryngoscopy / Q000379:methods*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011292:Premedication; D013610:Tachycardia / Q000139:chemically induced
chemical_list: D000777:Anesthetics; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine