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.