Comparing the Effect of Dexmedetomidine and Remifentanil on Hemodynamic Indices in Children Undergoing Endotracheal Intubation: A Randomized Clinical Trial

Painful stimulation during laryngoscopy and endotracheal intubation results in increased hemodynamic side effects. The aim of current study was to compare the effects of intranasal dexmedetomidine and remifentanil on reduction of hemodynamic changes following endotracheal intubation in children undergoing general anesthesia. A double-blind clinical trial was performed in 104 children aged 6-12 years old, undergoing general anesthesia in Isfahan Imam Hossein Hospital, Iran, 2017-2018. Patients were randomly assigned into three groups to receive intranasal (IN) remifentanil 4µg/kg, dexmedetomidine 2µg/kg (IN), or normal saline 1mL, 0.9% (IN) before the induction of anesthesia. Hemodynamic changes were recorded at one and five minutes following intubation. ANOVA and Chi-square were applied to analyze the data. Heart rate was higher in patients receiving normal saline and lower in patients
receiving dexmedetomidine (p=0.22). Mean arterial blood pressure (p=0.98) and arterial oxygenation (p=0.81) were not significantly different between the three groups. No significant side effects were observed in any group. Administration of pre-intubation intranasal dexmedetomidine, results in heart rate stabilization following intubation.