Octava Prima ARTA, Raihanita ZAHRA, Christopher KAPUANGAN, Indro MULYONO, Arif H. M. MARSABAN, Aldy HERIWARDITO
Turkish Journal of Anaesthesiology and Reanimation - 2026;54(3):169-175
Objective: To evaluate the effect of a single intranasal dose of dexmedetomidine (2 µg kg-1) on intubation efficacy , mask acceptance, sedation quality , intubation duration, and intraoperative fentanyl consumption in children undergoing elective surgery . Methods: A randomized, double-blind, placebo-controlled trial was conducted in 40 American Society of Anaesthesiologists I-II children aged 1-6 years who were scheduled for elective surgery . Participants were randomized to receive either dexmedetomidine (n = 20) or 0.9% sodium chloride placebo (n = 20). All patients received intravenous midazolam as a routine premedication. Primary outcomes were mean arterial pressure (MAP) and heart rate (HR), measured at baseline and post-intubation; these were compared to assess intubation efficacy . Secondary outcomes included mask acceptance, sedation quality , intubation time, and total fentanyl consumption. Data were analyzed using the independent-samples t-test or the Mann-Whitney U test ( P < 0.05). Results: Dexmedetomidine maintained MAP (1.34 +/-19.59%) versus a significant rise with placebo (21.95 +/-26.36%; P=0.008) and limited HR increase (1.6% vs. 22.2%; P < 0.001). Mask acceptance and adequate sedation were significantly higher ( P < 0.001). Intubation duration did not differ (median 39 seconds vs. 44 seconds; P=0.267). Fentanyl consumption was significantly lower (1.10 vs. 2.15 µg kg-1; P < 0.001). Conclusion: A single intranasal dose of dexmedetomidine provides superior intubation efficacy , improves mask acceptance and sedation quality , and yields a significant opioid-sparing effect.
