ArticleFrontiers in pharmacology2025
Comparative evaluation of intravenous versus intranasal dexmedetomidine on emergence delirium and hemodynamics in pediatric patients undergoing adenotonsillectomy: a randomized controlled trial.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Intranasal esketamine plus dexmedetomidine versus dexmedetomidine alone for emergence delirium in pediatric patients: a systematic review and meta-analysis of randomized controlled trials.BMC anesthesiology · 2026Pooled it
- A Novel Standardized Dexmedetomidine Nasal Spray Formulation for Procedural Sedation During Venous Port Implantation: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.Drug design, development and therapy · 2026Trial
- The Impact of Intranasal Esketamine on Emergence Agitation in Children Undergoing Adenotonsillectomy: A Randomized Controlled Study.Drug design, development and therapy · 2025Trial
- Association between intranasal dexmedetomidine dose and delayed awakening after sedation in children: a retrospective cohort study.BMC anesthesiology · 2026Article
- Rapid quantification and validation of etomidate and dexmedetomidine blood concentrations in rats using a novel portable mass spectrometer.Frontiers in veterinary science · 2025Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Dexmedetomidine effectively prevents emergence delirium in children. However, intravenous dexmedetomidine is frequently associated with hemodynamic instability and delayed recovery. Intranasal dexmedetomidine has been proposed as a method of reducing these side effects. This study aimed to evaluate the effects of intranasal versus intravenous dexmedetomidine on emergence recovery and hemodynamics in children undergoing adenotonsillectomy. Methods: A total of 139 children, aged 3-10 years, who were scheduled for elective adenotonsillectomy were randomly assigned to receive intravenous dexmedetomidine (IV DEX group) or intranasal dexmedetomidine (IN DEX group), or saline (control group) after anesthesia induction. The primary outcome was the highest score on the pediatric anesthesia emergence delirium (PAED) score during the first 30 min after awakening. Secondary outcomes included the perioperative blood pressure and heart rate, time to awakening, postoperative pain score, and length of post-anesthesia care unit (PACU) stay. Results: The highest PAED and pain scores were significantly lower in the IV and IN DEX groups than those in the control group during the first 30 min after awakening. However, no significant differences were observed between the IV and IN DEX groups. Notably, patients in the IN DEX group exhibited a significantly lower PAED score at 2 h and lower pain scores at 2, 4, and 6 h postoperatively than those in the IV DEX group. Patients in the IV DEX group exhibited a significantly longer awakening time and length of PACU stay than those in the IN DEX and control groups. In the IV DEX group, the heart rate was significantly lower perioperatively than at baseline, while this effect was not observed in the IN DEX group. Conclusion: Both intravenous and intranasal administration of dexmedetomidine after induction of anesthesia effectively improved emergence delirium and pain intensity in children undergoing adenotonsillectomy. Intranasal administration of dexmedetomidine provided more stable hemodynamics and more prolonged analgesia and sedation than intravenous infusion of dexmedetomidine. Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=180658.
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