Administering anesthesia to children is both a profound responsibility and a source of immense joy for me. The unique physiological and anatomical characteristics of pediatric patients necessitate a tailored approach to ensure their safety and comfort. One of the most challenging aspects is guiding young children to the operating room without inducing fear or anxiety.
Over the years, I’ve utilized various premedication agents such as promethazine, midazolam, and ketamine to ease this transition. However, dexmedetomidine, affectionately known as Dexem, has emerged as a standout choice in my practice. This gentle yet effective sedative has transformed the perioperative experience for many of my young patients.
The typical scenario of a five-year-old feeling overwhelmed by masked adults, bright lights, and beeping machines is heart-wrenching. Dexem helps alleviate this distress. After receiving intranasal dexmedetomidine, administered at a dose of 2-3 mcg/kg approximately 30 minutes before surgery, children often exhibit a calm demeanor, willingly entering the operating room and accepting the anesthesia mask without resistance. This method is particularly favored in our institution due to its non-invasive nature, though it’s worth noting that some children might experience mild nasal irritation upon administration.
While Dexem is generally well-tolerated, it’s essential to monitor for potential side effects such as postoperative sedation, bradycardia, and hypotension. These effects underscore the importance of vigilant postoperative monitoring to ensure each child’s safety and well-being.
Incorporating dexmedetomidine into pediatric anesthesia has significantly enhanced the surgical experience for both children and their families. Witnessing a child transition smoothly through the perioperative process, free from undue stress and fear, reaffirms the profound impact of compassionate and tailored anesthetic care.
Written By
Dr Jiny Chandran
Senior Consultant, Department of Anaesthesia
Baby memorial hospital