title: Intranasally Administered Adjunctive Dexmedetomidine Reduces Perioperative Anesthetic Requirements in General Anesthesia.
abstract: OBJECTIVE
  Intranasal dexmedetomidine is an effective sedative for premedication and is regularly used to reduce preoperative tension and anxiety in children. This study aimed to assess the effect of intranasally adjunctive dexmedetomidine on perioperative sedative and analgesic requirements in adults.
  
  
  METHODS
  Patients were randomly divided into four groups to receive preoperative administration of saline, intranasal dexmedetomidine 1 μg/kg and 2 μg/kg, and intravenous dexmedetomidine 1 μg/kg, respectively. Propofol and remifentanil were target-controlled infused to maintain intraoperative bispectral index at 45-55 and blood pressure at baseline value±20%. Sufentanil was administered to maintain postoperative visual analogue scale ≤3. Perioperative anesthetics requirements were compared using nonparametric tests.
  
  
  RESULTS
  Intranasal dexmedetomidine significantly attenuated propofol requirements for anesthesia induction and maintenance in a dose-dependent manner. Patients given intranasal dexmedetomidine 2 μg/kg required less remifentanil for anesthesia maintenance. The first postoperative request for sufentanil analgesia was delayed in patients given intranasal dexmedetomidine 2 μg/kg. The anesthetics-sparing effect of intranasal dexmedetomidine was significantly weaker than intravenous dexmedetomidine at the same dose of 1 μg/kg. The incidences of adverse events, including hemodynamic instability and delayed recovery, were comparable with and without intranasal dexmedetomidine.
  
  
  CONCLUSIONS
  Intranasal administration of dexmedetomidine can reduce perioperative anesthetic requirements, and a dose of dexmedetomidine 2 μg/kg produces a better effect in adults. The anesthetics-sparing effect of intranasal dexmedetomidine 1 μg/kg is less than that with the same intravenous dose of dexmedetomidine.
authors.affiliation: Department of Anesthesiology, The Affiliated Hospital of School of Medicine of Ningbo University, Ningbo, Zhejiang, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
authors.forename: Li Hua
authors.initials: LH
authors.lastname: Hang
authors.affiliation: Department of Anesthesiology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
authors.forename: Dong Hua
authors.initials: DH
authors.lastname: Shao
authors.affiliation: Department of Anesthesiology, The Affiliated Hospital of School of Medicine of Ningbo University, Ningbo, Zhejiang, China.
authors.forename: Yi Guo
authors.initials: YG
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology, The Affiliated Hospital of School of Medicine of Ningbo University, Ningbo, Zhejiang, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cui
authors.affiliation: Department of Anesthesiology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China. chenzheng198590@sina.com.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Chen
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000768:Anesthesia, General; D002648:Child; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019990:Perioperative Care; D011292:Premedication
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine
keywords: Dexmedetomidine; administration, intranasal; anesthetics, intravenous