COMPARISON OF INTRANASAL DEXMEDETOMIDINE AND INTRANASAL CLONIDINE AS SEDATIVE PREMEDICATION IN PAEDIATRIC ANAESTHESIA : A RANDOMIZED CLINICAL STUDY

Dr Shashank Maladkar; Dr Karthik Shivani Lokeshappa; Dr Chennagiri Gangappa Ravindra

Volume : VIII, Issue : III, March - 2018

COMPARISON OF INTRANASAL DEXMEDETOMIDINE AND INTRANASAL CLONIDINE AS SEDATIVE PREMEDICATION IN PAEDIATRIC ANAESTHESIA : A RANDOMIZED CLINICAL STUDY

Dr Shashank Maladkar, Dr Karthik Shivani Lokeshappa, Dr Chennagiri Gangappa Ravindra

Abstract :

Adequate premedication is an integral and important component of paediatric anaesthesia which should alleviate anxiety, allow comfortable separation of the child from the parent for smooth conduct of anaesthesia. Clonidine and dexmedetomidine are selective alpha‑2 agonists with sedative and analgesic effects, which are effective through the nasal route. Both the drugs are being increasingly used in paediatric anaesthesia as a premedication and as an adjuvant in general as well as regional anaesthesia. We conducted a study to compare effectiveness of intranasal dexmedetomidine and clonidine as sedative premedication in paediatric patients undergoing various surgeries.

MATERIALS AND METHODS

After obtaining Institutional Ethical Committee clearance and parent’s consent, a prospective, randomised, double–blinded clinical study was conducted in 80 children of ASA I and II, belonging to 2 – 10 years age, posted for various elective surgery. Group D (n= 40) received intranasal dexmedetomidine (2 mcg/kg) and Group C (n= 40) received clonidine (4 mcg/kg) instilled into both the nostrils. Sedation score (Ramsay), separation score, mask acceptance, recovery and vital parameters were recorded. Statistical analysis of data was done using IBM–SPSS version 21.0.

RESULTS

Mean sedation scores (± SD) were higher in Group D than in Group C at all time interval with a statistical significant difference at 25^th and 30^th minutes(P<0.05). Separation scores were better with Group D than Group C (P<0.05). Mask acceptance scores were better with group C than group D. cardio–pulmonary parameters were similar in both the groups and no major adverse effects were noted.

CONCLUSION

Intranasal dexmedetomidine was associated with superior sedation levels and easier child–parent separation than clonidine and it appears to be a better choice for pre–anaesthetic medication.