Intranasal Dexmedetomidine And Midazolam For Premedication Of Pediatric Patients Undergoing Tonsillectomy Anesthesia

Objective This study was to compare of the effect of dexmedetomidine and midazolam on preoperative anxiety and postoperative restlessness,by designing to observe a single intranasal instillation of the two medications before anesthesia in pediatric tonsillectomy patients.In order to provide a reference for a single intranasal instillation of dexmedetomidine in the pediatric patients.Methods Sixty-three children who were undergoing tonsillectomy,aged 3～8 years,weighing 15～30 kg,ASA Ⅰ～Ⅱ level,were randomly assigned to one of three equal groups(n=21).Group A received intranasal dexmedetomidine(1.0ug/kg),group B received intranasal midazolam(0.2mg/kg)and group C received intranasal the same volume normal saline before induction of anesthesia 20min.Using inhalation anesthesia to complete the surgery of all of the patients with endotracheal intubation.The patients’ basic emotions,mask acceptance,hemodynamic parameters and sedation status were recorded by an observer until anesthesia induction.The anesthesia time,operation time,recovery time,extubation time,postoperative agitation and adverse reactions were also observed and recorded,as well as who received sedative analgesic to comfort.Results(1)The sedation status scores when the children went intooperating room of group A and B were significantly lower than group C(P<0.05).The contrast on sedation status scores of group A and B was no significant difference(P>0.05).(2)Anesthesia time,operation time,recovery time and extubation time of the three groups were no significant difference(P>0.05).(3)In recovery period(T0,T1 and T2),the restlessness scores of group A and B were significantly lower than group C(P<0.05).The restlessness scores of group A in the wake 5min(T1)slightly lower than group B(P<0.05).In recovery period(T3 and T4),the restlessness scores of three groups were no significant difference(P>0.05).(4)The rates of the three groups of children in the PICU who received sedative analgesic to comfort were 9.5%,23.8%,47.6%.Conclusion Intranasal dexmedetomidine(1.0ug/kg)and midazolam(0.2mg/kg)are an effective and safe alternative for premedication of pediatric patients undergoing tonsillectomy anesthesia.Either of them are able to reduce children’ anxiety when they are separated from their parents,provide a good conditions for induction of anesthesia and cut down the rates of postoperative restlessness.In the same time,the two drugs do have a little of effect on the children’s recovery time.However,intranasal dexmedetomidine(1.0ug/kg)can results in lower postoperative restlessness scores in comparison to intranasal midazolam(0.2 mg/kg).