Randomized trials
Nose or vein for dexmedetomidine after tonsil surgery?
Open access · cc by · source: Europe PMC
In 139 children, IV 1 μg/kg and IN 2 μg/kg dexmedetomidine both lowered peak PAED vs saline (8.3 vs 10.3), but only IV slowed heart rate and prolonged PACU stay.
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Study at a glance
- Design
- RCT — Three-arm randomized trial of IV vs intranasal dexmedetomidine vs saline after induction for pediatric adenotonsillectomy (ChiCTR2200065404)
- N
- N=139 · 139 randomized children 3–10 years (IV DEX 47, IN DEX 47, control 45) after 141 screened
- Population
- Children 3–10 years undergoing elective adenotonsillectomy
- Outcome
- Highest PAED score in first 30 min after awakening; pain, awakening/PACU times, and perioperative heart rate
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Nose or vein for dexmedetomidine after tonsil surgery?
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
139 children aged 3–10 years were randomized.
A total of 139 children, aged 3–10 years
Peak PAED means were 8.3, 8.3, and 10.3.
IV DEX group, 8.3 [2.2]; IN DEX group, 8.3 [2.1]; control group, 10.3 [2.2]; P < 0.001
Key findings
Peak PAED 8.3 (IV) / 8.3 (IN) / 10.3 (control), P<0.001 vs control, no IV–IN difference early on. IN had lower PAED at 2 h and lower pain at 2–6 h. IV had longer wake/PACU times and lower perioperative HR.
Methodology
Randomized 139 kids (3–10 y) after induction to IV dexmedetomidine 1 μg/kg, IN 2 μg/kg, or saline; primary outcome was highest PAED in 30 min after waking, plus pain, hemodynamics, and PACU time (ChiCTR2200065404).
Limitations
Single-center adenotonsillectomy results may not generalize to other surgeries or unsedated IN premedication; PAED is a scale, not long-term neurodevelopment.
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