The Study Of Intranasal Dexmedetomidine Sedation In Children For Electroencephalogram

Objective:?1?To explore the median effective intranasal dose of dexmedetomidine sedation for electroencephalogram in children.?2?To compare two different doses of intranasal dexmedetomidine applied to epileptic children for electroencephalogram sedation.Methods:?1?We enrolled 39 children with intranasal dexmedetomidine sedation for electroencephalogram in Children's Hospital of Chongqing Medical University from October 25,2016 to October 25,2017,aged 1⁶years old,American Society of Anesthesiologists?ASA??^?.Experiment were conducted by the method of using a double-blind,sequential,prospective study.According to the preliminary experimental results,the initial dose was 2.0?g/kg.Effective standard of sedation was achieved when the Ramsay Sedation Scale?RSS?scores reached 4points and the children's eyelashes had no reflective activity.By the sedation of the previous patient,the intranasal dose of the next patient was determined on the 0.2?g/kg ladder.The trial was stopped when the negative and positive results reached 8 inflection points.?2?Sixty epileptic children between 1 and 6 years of age with American Society of Anesthesiologists Physical Status classification I or II who were scheduled intranasal dexmedetomidine sedation for electroencephalogram?EEG?.Experiment were conducted by the method of using a prospective randomized double-blind study.The random numbers table was used to divide them into two groups of 2?g/kg?group A?and3?g/kg?group B?.After 20 mins of medication,the Ramsay Sedation Scale scores reached 4points was considered to achieve sedative standard.Then analyze the EEG sleep stage and the effects of post-medication on EEG background activity.Record the Arousal satisfaction scores and the onset time of sedation,the time to complete the EEG examination and total duration of sedation,as well as related adverse reactions.Results:?1?The Median Effective Intranasal Dose(ED₅₀)of dexmedetomidine in children for electroencephalogram was 2.10?g/kg,and the 95%confidence interval?Confidence Interval,CI?was?1.955².255??g/kg.?2?The general situations related to weight and age were not statistically different between two groups.the score of Ramsey's sedation in both groups reached 4 points,but the score of group A was less than group B?P<0.01?.The Non-Rapid Eye Movement?NREM?sleep stage 2was more in group A,NREM sleep stage 3was less in group A?P<0.01?.Only one child appeared increased post-medication EEG background rapid activity in group A.Compared with group B,group A were significantly higher in the Arousal satisfaction?P<0.01?.The results related to the time to complete the EEG examination and total duration of sedation were higher in group B,the falling asleep time of sedation were not statistically different.No adverse events occurred and all the children completed EEG examination.Conclusion:?1?2.10?g/kg dexmedetomidine nasal drip can make 50%electroencephalogram examination children achieve effective sedation state,do not interfere with epileptic form discharge detection,sedative effect is satisfactory,the respiratory and circulatory system is less affected.?2?The two intranasal doses of groups were achieve safe and effective sedation,but the Arousal satisfaction,epilepsy detection rate and sedation efficiency were higher in group A.Therefore,to give the epileptic children of intranasal dexmetomidine 2?g/kg in electroencephalogram sedation is more recommended.