title: Sedation effects of intranasal dexmedetomidine delivered as sprays versus drops on pediatric response to venous cannulation.
abstract: OBJECTIVE
  Mucosal atomization device (MAD) was designed to increase the bioavailability of intranasal medications by facilitating absorption, the present study aimed to evaluate and compare the sedation effects of intranasal dexmedetomidine delivered as drops versus sprays on pediatric responses to intravenous cannulation.
  
  
  METHODS
  One hundred and six pediatric patients (aged from 2 to 5years) scheduled for elective ophthalmic surgery were intranasally received a dose of 2μg/kg in 20μl/kg of dexmedetomidine for sedation to reduce response to venous cannulation. The patients were randomized into syringe group and MAD group in which dexmedetomidine was delivered as drops or sprays via syringe or MAD respectively. The primary outcome was the response to peripheral vein cannulation assessed by the FLACC scores (faces, legs, activity, cry and consolability) 30min after intranasal administration of dexmedetomidine. The secondary outcomes included acceptance for intranasal medication, sedation onset time, and needle insertion times and any adverse event at the preoperative holding area.
  
  
  RESULTS
  The FLACC scores in MAD group were significantly decreased than that treated by drops (P=0.021). The acceptance for intranasal administration between both groups was comparable (P>0.05), the onset time and the incidences in two and more times of needle insertion did not differ significantly between syringe and MAD groups (all P>0.05). None of patients were required to clinically intervene in heart rates reduction and none suffered respiratory depression after administrations of dexmedetomidine in either group.
  
  
  CONCLUSIONS
  Intranasal dexmedetomidine by sprays offers better sedation effects to reduce responses to venous cannulation than drops.
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Zhubin
authors.initials: Z
authors.lastname: Xie
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Shen
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Jingyi
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Liwen
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Minyan
authors.initials: M
authors.lastname: Liao
authors.affiliation: Department of Anesthesiology, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China. Electronic address: ganxl@mail.sysu.edu.cn.
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Gan
mesh_terms: D000281:Administration, Intranasal; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002675:Child, Preschool; D002681:China; D002985:Clinical Protocols; D016292:Procedural Sedation / Q000379:methods*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D009330:Nebulizers and Vaporizers; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D009883:Ophthalmic Solutions; D020927:Dexmedetomidine
keywords: Cannulation; Dexmedetomidine; Sedation