What does this research mean for the field?

Oral dexmedetomidine (3 mcg/kg) is as effective as intranasal dexmedetomidine (1 mcg/kg) for premedication in children undergoing minor surgical procedures. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate and compare the efficacy of dexmedetomidine administered intranasally versus orally as premedication in children undergoing minor surgical procedures.

March 10, 2026Open Access

Comparative evaluation of dexmedetomidine as a premedication given intranasally vs orally in children between 1 to 8 years of age undergoing minor surgical procedures.

Key Points

To evaluate and compare the efficacy of dexmedetomidine administered intranasally versus orally as premedication in children undergoing minor surgical procedures.
Randomized trial involving 54 children aged 1 to 8 years
Group I received 1 mcg/kg dexmedetomidine intranasally
Group II received 3 mcg/kg dexmedetomidine orally 45 minutes before anesthesia
Sedation depth assessed using modified Observer Assessment of Alertness/Sedation Scale
Mask acceptance and hemodynamic parameters were recorded at induction.
Initial sedation scores were higher in the intranasal group, but final scores were similar in both groups.
No differences in mask acceptance or hemodynamic parameters were observed at induction.
Both routes blunted the hemodynamic response by less than 20% increase in heart rate at induction.

Abstract

Background Dexmedetomidine has been used as a premedication in children primarily via nasal route. Concerns regarding bioavailability and onset of action has restricted its use via oral route. However, oral route is natural and more pleasurable compared to nasal. We compared dexeme- detomidine given as a premedication via nasal and oral routes in children undergoing minor surgical procedu- res. Methods 54 children of ASA PS I grade, aged 1to 8 years, were randomised to one of the two groups. Group I received 1mcg/kg dexmedetomidine intranasally while group II received 3 mcg/kg dexmedetomidine orally, 45 minutes prior to induction of anaesthesia. Depth of sedation was assessed using modified Observer Assessment of Alert- ness/Sedation Scale just before premedication and every 10 minutes thereafter, till parental separation. Mask ac- ceptance , baseline, minimum and maximum heart rates, at induction were recorded along with post operative complications. Results Though initial sedation scores dropped rapidly in group I compared to group II, final sedation scores were simi- lar in both the groups. There were no difference in the two groups in terms of mask acceptance and hemody- namic parameters at induction. Both the groups showed blunting of hemodynamic response (<20% increase in heart rate) at induction. Conclusion Oral dexmedetomidine (3 mcg/kg) is as effective a pre- medication as intranasal dexmedetomidine (1 mcg/kg). Dexmedetomidine premedication, in doses and via rou- tes used in this study, blunts hemodynamic response at induction of anaesthesia.

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