The effect of nebulized dexmedetomidine as sedative premedication in pediatrics undergoing cochlear implantation

Abstract

ABSTRACT Background Sedation is crucial part of the management of cochlear implant surgery. Preoperative anxiety is more aggravated in deaf children due to limited communication. The aim of the present study was to investigate the efficacy and safety of two different doses of nebulized dexmedetomidine in deaf children undergoing cochlear implantation. Patients and Methods Fifty patients undergoing cochlear implantation were randomly allocated into two equal groups, D3 and D4, and were premedicated by nebulized three and four μg/kg dexmedetomidine, respectively, 30 min before induction of anesthesia. Results The depth of sedation in D4 group was comparable with that of D3 group. The onset of sedation and the time to maximum sedative effect were significantly earlier in D4 than in D3 group. BIS score at admission to operating theater was significantly lower in D4 than in D3 group. The level of parental separation anxiety, the degree of ease of venipuncture, and the severity level of emergence agitation were comparable in both groups. The quality of surgical field was significantly better, and the recovery time was significantly shorter in D4 group than in D3 group. The level of heart rate and mean blood pressure were significantly lower, and the rate of bradycardia and hypotension were significantly higher in D4 group than in D3 group. Conclusions Premedication by each of three and four μg/kg of nebulized dexmedetomidine provides a satisfactory sedation level that facilitate parental separation and intravenous cannulation, but three μg/kg was superior because it was associated with lower frequency of side effects.