Study of Feasibility and Safety of Higher-Dose Dexmedetomidine in Special Outpatient Examination of Pediatric Ophthalmology.

Chaoqiao Chen,Zhangliang Li,Li Nie,Gang Chen,Minji You,Yune Zhao

doi:10.1155/2019/2560453

Chaoqiao Chen, Zhangliang Li + Show 4 more

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https://doi.org/10.1155/2019/2560453

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Abstract

Objective To investigate the feasibility and safety of higher-dose dexmedetomidine in ophthalmological outpatient examination of children with cataract. Methods 100 cases of children were recruited in the study and randomly equally divided into two groups. One group was given 2 μg/kg intranasal dexmedetomidine anesthesia, while the other group was under 3 μg/kg. The dosage of dexmedetomidine was calculated by the same anesthesiologist according to the weight of patient. After sufficient sedation, the same ophthalmologist performed ocular examinations manually, including intraocular pressure, keratometry, axial length, and corneal thickness and recorded the ocular position score during intraocular pressure measurement and corneal thickness measurement. Other variables were sedation onset time, recovery time, vital signs, and side effects. Results In intraocular pressure measurement, only one case in the 2 μg/kg group did not complete the examination, while all cases in the 3 μg/kg group completed the examination and the difference of the success rate between the two groups was nonsignificant (P > 0.05). The success rates of the 3 μg/kg group in corneal curvature, axial length, and corneal thickness examination were 96%, 92%, and 86%, respectively, which were significantly higher than those of the 2 μg/kg group (22%, 18%, and 4%). The average onset time of sedation in the 3 μg/kg group was 15.42 ± 2.09 minutes, which was significantly shorter than that in the 2 μg/kg group (19.52 ± 2.43 minutes, P < 0.001). The average time of completing all examinations in the 3 μg/kg group was 18.36 ± 4.01 minutes, which was significantly shorter than that in the 2 μg/kg group (22.62 ± 4.13 min, P < 0.001). The recovery time of group 3 μg/kg was 90.62 ± 27.80 min, which was significantly longer than that of group 2 μg/kg (49.20 ± 15.50 min). Vital signs such as pulse, blood pressure, oxygen saturation, and heart rate kept in normal range throughout the tests, and no obvious side effects were observed. Conclusion 3 μg/kg intranasal dexmedetomidine had a higher sedation success rate and quality than 2 μg/kg did in pediatric ocular examinations, without any obvious side effects.

Highlights

IntroductionChildren bearing this disease need special preoperative outpatient examination in order to prepare the intraocular lens, preevaluate the postoperative complications and decide the vision training procedures [1,2,3]
We aim to examine the effect of higher-dose dexmedetomidine (3 μg/kg) in the special outpatient examination of pediatric ophthalmology and evaluate its feasibility and safety
Children with congenital cataract aged from 6 to 24 months with American Society of Anesthesiologists (ASA) physical status 1-2 were enrolled in this study, either surgery or postoperative examination needed. e physical status of patient was thoroughly evaluated before sedation

Summary

Introduction

Children bearing this disease need special preoperative outpatient examination in order to prepare the intraocular lens, preevaluate the postoperative complications and decide the vision training procedures [1,2,3]. Us, sedation is an essential part in the examination of children [4]. E clinical application of sedatives has some limitations since sedation depth is often not achieved in great individual variability as well as frequent complications, such as hypoxemia, emesis, and irritation [5]. Compared with other clinical anesthetic drugs, dexmedetomidine has advantages in reducing anesthetics and opioid consumption, postoperative rigors, phrenitis, and dysphoria in analepsia stage [6]

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