Comparative Study of Dexmedetomidine Administration Routes in Pediatric Patients Receiving Endoscopic Low-temperature Plasma Adenotonsillar Ablation.

This study aimed to explore the effects of different dexmedetomidine (DEX) administration routes on anesthesia quality in pediatric patients undergoing endoscopic low-temperature plasma adenotonsillar ablation. We selected 120 children with obstructive sleep apnea hypopnea syndrome scheduled for surgery between May and December 2023. Participants were divided into four groups (n=30 each): a control group (Group S) receiving standard anesthesia without DEX; a local anesthesia group (Group L) receiving ropivacaine infiltration with 0.3 µg·kg-1 DEX; an intravenous group (Group T) receiving 0.6 µg·kg-1 DEX infusion post-induction; and a nasal drip group (Group N) receiving 0.6 µg·kg-1 DEX intranasally upon room entry. We compared operation/extubation/recovery times, and scores from the Observer Assessment of Alertness and Sedation (OAA/S), Objective Pain Scale (OPS), and Pediatric Anesthesia Emergence Delirium (PAED) scales. Rescue sedation and safety were also assessed. Group T showed lower heart rates at specific timepoints, while Group L had lower blood pressures. Recovery time (Steward score ≥4) was longer in Groups L and T compared to Group S, but not in Group N. Groups T and N showed increased OAA/S scores post-awakening, with Group N having the highest scores. OPS and PAED scores decreased in all DEX groups, with Group N demonstrating the lowest scores, followed by Group L and then Group T. No significant differences were found in operation time, extubation time, or the incidence of rescue sedation/complications among groups. Intranasal DEX emerged as the optimal route, providing effective analgesia and sedation without prolonging recovery time.