Comparative Study of Dexmedetomidine Administration Routes in Pediatric Patients Receiving Endoscopic Low-temperature Plasma Adenotonsillar Ablation

Kaiying  Song; Ling  Li; Peijun  Li; Xuetao  Yan; Yongmei  Zhao; Yongmei  Zha; Huiqin  Lu; Zigang  Liu

doi:10.18502/ijaai.v25i3.21256

Kaiying Song Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Ling Li Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Peijun Li Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Xuetao Yan Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Yongmei Zhao Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Yongmei Zha Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Huiqin Lu Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China
Zigang Liu Shenzhen Baoan Women’s and Children’s Hospital, Shenzhen, China

DOI: https://doi.org/10.18502/ijaai.v25i3.21256

Keywords: Adenoidectomy; Anesthesia recovery period; Child; Dexmedetomidine; Postoperative complications; Tonsillectomy

Abstract

This study aimed to explore the effects of different dexmedetomidine (DEX) administrationroutes on anesthesia quality in pediatric patients undergoing endoscopic low-temperature plasmaadenotonsillar ablation.We selected 120 children with obstructive sleep apnea hypopnea syndrome scheduled forsurgery between May and December 2023. Participants were divided into four groups (n=30 each):a control group (Group S) receiving standard anesthesia without DEX; a local anesthesia group(Group L) receiving ropivacaine infiltration with 0.3 μg·kg−1 DEX; an intravenous group (Group T)receiving 0.6 μg·kg−1 DEX infusion post-induction; and a nasal drip group (Group N) receiving 0.6μg·kg−1 DEX intranasally upon room entry. We compared operation/extubation/recovery times,and scores from the Observer Assessment of Alertness and Sedation (OAA/S), Objective PainScale (OPS), and Pediatric Anesthesia Emergence Delirium (PAED) scales. Rescue sedation andsafety were also assessed.Group T showed lower heart rates at specific timepoints, while Group L had lower bloodpressures. Recovery time (Steward score ≥4) was longer in Groups L and T compared to Group S,but not in Group N. Groups T and N showed increased OAA/S scores post-awakening, withGroup N having the highest scores. OPS and PAED scores decreased in all DEX groups, withGroup N demonstrating the lowest scores, followed by Group L and then Group T. No significantdifferences were found in operation time, extubation time, or the incidence of rescuesedation/complications among groups.Intranasal DEX emerged as the optimal route, providing effective analgesia and sedationwithout prolonging recovery time.