THE EFFECT OF TWO DOSES OF NEBULISED DEXMEDETOMIDINE FOR PREMEDICATION OF PEDIATRIC PATIENTS-A RANDOMISED STUDY

Preoperative anxiety is seen in 50%-70% of the pediatric patients posted for surgery1.Fear of parent separation,fear of strange hospital environment and painful procedures contribute to preoperative anxiety2.Children with high preoperative anxiety have high incidence of postoperative pain,emergence delirium, delayed discharge and maladaptive and behavioural  changes that can last for weeks in postoperative period3.Various drugs have been advocated as premedication to allay anxiety,reduce fear of parental separation and facilitate smooth induction of anesthesia.To date,there is no widely accepted standard regimen or an ideal route of administration for  premedication .The ideal premedicant in children should be readily acceptable and should have a rapid and reliable onset with minimal side effects.Inhalation of nebulised drug is an easy alternative for preoperative sedation as it avoids needle puncture.However, systemic absorption of the nebulised drug depends on multiple factors,such as dosage of the drug,properties  of the drug and nebulizer used.Other drugs such as midazolam , ketamine have been tried via oral,nasal and parenteral routes, but each one has its own limitations4.                                                              Dexmedetomidine ,a selective alpha-2 agonist with central sedative and anxiolytic,has been tried as  preoperative anxiolytic  via nasal and inhalational routes in pediatric patients.Dexmedetomidine nebulisation is an attractive option as pediatric premedication.However,the effective dose is not well established in pediatric patients.So in our study,we want to compare the doses of 2 mcg/kg and 3mcg/kg and study their effects.The null hypothesis of our study is that there is no difference in parental separation and mask acceptance in patients when 2mcg/kg or 3 mcg/kg dexmedetomidine is used as premedication.

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