title: Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane.
abstract: OBJECTIVE
  This study aimed to test the hypothesis that premedication with a single dose of intranasal dexmedetomidine (DEX) could not only reduce preoperative anxiety but also minimize the emergence agitation in children undergoing cataract surgery with sevoflurane anesthesia.
  
  
  METHODS
  Single-blinded, randomized, placebo-controlled clinical comparison study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Ninety American Society of Anesthesiologists physical status 1 and 2 children scheduled for cataract surgery.
  
  
  METHODS
  Patients were randomized into 3 groups: group D1, group D2, and saline group (group C), in which the children received 1 or 2 μg/kg of intranasal DEX or saline, respectively, and each group comprises 30 patients.
  
  
  METHODS
  The mask induction score and the incidences of postoperative emergence agitation evaluated by the Pediatric Anesthesia Emergence Delirium scale were assessed. The emergence time, postanesthesia care unit (PACU) stay time, and any adverse events were recorded.
  
  
  RESULTS
  The mask induction scores were significantly higher in the saline group than those in the D1 and D2 groups (P<.001). The incidences of emergence agitation in the D1 and D2 groups were significantly lower than that in the saline group (7/30 in group D1 and 3/30 in group D2 vs 24/30 in group C, P<.001). The emergence time and PACU stay time were comparable among the 3 groups (P>.05). The emergence time and PACU stay time did not differ significantly in DEX-treated groups as compared with the saline group; there were no differences between 1- and 2-μg/kg groups. None of the patients exhibited significant clinical complications.
  
  
  CONCLUSIONS
  Intranasal DEX (1 or 2 μg/kg) dose independently improves the incidences of mask acceptance and prevents the incidences of postoperative emergency agitation mainly from sevoflurane without delaying the emergency time or inducing severe adverse events.
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Yiquan
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Jingxia
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Shen
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Qianru
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Hongfeng
authors.initials: H
authors.lastname: Ling
authors.affiliation: Department of Anesthesiology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China. Electronic address: ganxiaoliang@yeah.net.
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Gan
mesh_terms: D000281:Administration, Intranasal; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation / Q000379:methods*; D018685:Anesthetics, Inhalation; D002387:Cataract Extraction / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D008738:Methyl Ethers; D011229:Preanesthetic Medication; D011595:Psychomotor Agitation / Q000517:prevention & control*; D000077149:Sevoflurane; D016037:Single-Blind Method
chemical_list: D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D020927:Dexmedetomidine
keywords: Agitation; Children; Dexmedetomidine; Induction; Sevoflurane