Study of Feasibility and Safety of Higher-Dose Dexmedetomidine in Special Outpatient Examination of Pediatric Ophthalmology

Objective. To investigate the feasibility and safety of higher-dose dexmedetomidine in ophthalmological outpatient examination of children with cataract. Methods. 100 cases of children were recruited in the study and randomly equally divided into two groups. One group was given 2g/kg intranasal dexmedetomidine anesthesia, while the other group was under 3g/kg. The dosage of dexmedetomidine was calculated by the same anesthesiologist according to the weight of patient. After sufficient sedation, the same ophthalmologist performed ocular examinations manually, including intraocular pressure, keratometry, axial length, and corneal thickness and recorded the ocular position score during intraocular pressure measurement and corneal thickness measurement. Other variables were sedation onset time, recovery time, vital signs, and side effects. Results. In intraocular pressure measurement, only one case in the 2g/kg group did not complete the examination, while all cases in the 3g/kg group completed the examination and the difference of the success rate between the two groups was nonsignificant (P>0.05). The success rates of the 3g/kg group in corneal curvature, axial length, and corneal thickness examination were 96%, 92%, and 86%, respectively, which were significantly higher than those of the 2g/kg group (22%, 18%, and 4%). The average onset time of sedation in the 3g/kg group was 15.42 +/- 2.09minutes, which was significantly shorter than that in the 2g/kg group (19.52 +/- 2.43minutes, P<0.001). The average time of completing all examinations in the 3g/kg group was 18.36 +/- 4.01minutes, which was significantly shorter than that in the 2g/kg group (22.62 +/- 4.13min, P<0.001). The recovery time of group 3g/kg was 90.62 +/- 27.80min, which was significantly longer than that of group 2g/kg (49.20 +/- 15.50min). Vital signs such as pulse, blood pressure, oxygen saturation, and heart rate kept in normal range throughout the tests, and no obvious side effects were observed. Conclusion. 3g/kg intranasal dexmedetomidine had a higher sedation success rate and quality than 2g/kg did in pediatric ocular examinations, without any obvious side effects.