Dexmedetomidine Intranasal sebagai Premedikasi pada Pediatri

Rima Novisca Jasmadi

Abstract


Pendahuluan: Pembedahan merupakan pengalaman yang sangat menegangkan bagi pasien terutama bagi anak-anak, karena anak yang paling rentan terhadap ketakutan, kecemasan dan stres, hal ini terjadi karena kemampuan kognitif yang terbatas serta mereka masih sangat bergantung kepada orang lain. Pemberian obat intranasal merupakan rute alternatif yang efektif dan nyaman, terutama bagi anak-anak yang tidak kooperatif sebagai premedikasi.

Pembahasan: Dexmedetomidine merupakan α2 agonis yang sangat selektif. Alpha 2-agonis adenoreceptor semakin sering digunakan dalam perawatan anestesia karena efeknya yang bukan hanya menurunkan nada simpatik dan melemahkan respon stres terhadap anestesia dan pembedahan, tetapi juga menyebabkan sedasi dan analgesia. Kesimpulan: Penggunaan intranasal dexmedetomidine pada anak-anak menjadi topik yang menarik karena meningkatnya kebutuhan akan obat penenang yang mudah digunakan dan diterima dengan baik oleh anak-anak, dengan tingkat keberhasilan yang sangat tinggi dan profil keamanan yang sangat baik sehingga dapat digunakan oleh ahli anestesi maupun subspesialis pediatrik dalam prosedur premedikasi.

 

Kata kunci: Dexmedetomidine intranasal, Pediatri, Premedikasi

 

 

ABSTRACT

 

Introduction: Surgery is a very stressful experience for patients, especially for children, because children are the most vulnerable to fear, anxiety and stress, this happens because of limited cognitive abilities and they are still very dependent on others. Intranasal administration of drugs is an effective and convenient alternative route, especially for children who are not cooperative as premedication.

Discussion: Dexmedetomidine is a highly selective 2 agonist. Alpha 2-adenoreceptor agonists are increasingly being used in anesthesia care because of their effects that not only decrease sympathetic tone and attenuate the stress response to anesthesia and surgery, but also induce sedation and analgesia.

Conclusion: The use of intranasal dexmedetomidine in children is a topic of interest due to the increasing need for a sedative that is easy to use and well accepted by children, with a very high success rate and excellent safety profile, making it suitable for both anesthesiologists and pediatric subspecialists alike. in premedication procedures.

 

Keyword: Intranasal dexmedetomidine, Pediatrics, Premedication


Full Text:

PDF

References


Chatrath V, Kumar R, Upasna S, Thakur M. Intranasal Fentanyl, Midazolam and Dexmedetomidine as Premedication in Pediatric Patients. Anesth Essays Res. 2018; 12(3):748-753.

Mondardini MC, Amigoni A, Cortellazzi P, Palma AD, Navarra C, Picardo SG, dkk. Intranasal Dexmedetomidine in Pediatrics: Update of Current Knowledge. Minerva Medica. 2019; 85(12):1334-45.

McCann ME, Kain ZN. The management of preoperative anxiety in children: An update. Anesth Analg. 2001;93:98–105.

Lönnqvist PA, Habre W. Midazolam as premedication: Is the emperor naked or just half-dressed. Paediatr Anaesth. 2005;15:263–5.

Mahdavi A, Fallahinejad Ghajari M, Ansari G, Shafiei L. Intranasal Premedication Effect of Dexmedetomidine Versus Midazolam on the behavior of 2-6-year-old Uncooperative Children in Dental Clinic. J Dent (tehran) 2018;15:79–85.

Baier nM, Mendez ss, Kimm D, velazquez ae, schro- eder ar. Intranasal Dexmedetomidine: An Effective Sedative Agent For Electroencephalogram And Auditory Brain Response Testing. Paediatr anaesth. 2016;26:280–5.

Sulton c, Mccracken c, simon HK, Hebbar K, reynolds J, cravero J, et al. Pediatric Procedural Sedation Using Dex- Medetomidine: A Report From The Pediatric Sedation Research Consortium. Hosp Pediatr. 2016;6:536–44.

Yuen vM, Hui tW, irwin Mg, Yuen MK. A Comparison Of Intranasal Dexmedetomidine And Oral Midazolam For Premedi- Cation In Pediatric Anesthesia: A Double-Blinded Randomized Controlled Trial. Anesth Analg. 2008;106:1715–21.

Latief SA, Suryadi KA, Dachlan MR. 2002. Petunjuk Praktis Anastesiologi ed II. Jakarta. Bagian Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Indonesia.

Soenarjo, Marwoto, Witjaksono, Satoto H, Budiono U, Lian A, dkk. 2013. Anestesiologi. Semarang: Perhimpunan Dokter Spesialis Anestesi Dan Terapi Intensif (Perdatin) Cabang Jawa – Tengah.

Kain ZN, Wang SM, Mayes L, Caramico LA, Hofstadter MB. Distress during induction of anesthesia and postoperative behavioral outcomes. Anesth Analg. 1999; 88: 1042- 7.

Reich DL, Silvay G. Ketamine : an update on the first twenty-five years of clinical experience. Can J Anaesth. 1989;36:186-97.

Suzuki M, Haraguti S, Sugimoto K, Kikutani T, Shimuda Y, Sakamoto A. A low dose intravenous ketamine potentiates epidural analgesia after thoracotomy. Anesthesiology. 2006;105:111-9.

Newton A, Fitton L. Intravenous ketamine for adult procedural sedation in the emergency department : a prospective cohort study. J Emerg Med. 2008;25:498-501.

Adam F, Chauvin M, Manoir B, Langlois M, Sessler DI, Fletcher D. Small dose ketamine infusion improves postoperative analgesia and rehabilitation after total knee arthroplasty. Anesth Analg. 2005;100:457-80.

Sastroasmoro S, Ismael S. Dasar-dasar metodologi penelitian klinis. Edisi ke- 2. Jakarta: CV Sagung Seto; 2002. p. 273.

Sulaiman S, Karthekeyan RB, Vakamudi M, et al. The effects of dexmedetomidine on attenuation of stress response to endotracheal intubation in patients undergoing elective off- pump coronary artery bypass grafting. Ann Card Anaesth.2012;15:39–43.

Jun JH, Kim Kn, Kim JY, song sM. the effects of intra- nasal dexmedetomidine premedication in children: a system- atic review and meta-analysis. can J anaesth 2017;64:947–61.

linares segovia B, garcía cuevas Ma, ramírez casillas il, guerrero romero JF, Botello Buenrostro i, Monroy torres r, et al. [Pre-anesthetic medication with intranasal dexme- detomidine and oral midazolam as an anxiolytic. a clinical trial]. an Pediatr (Barc) 2014;81:226–31. spanish.

Miller JW, Balyan r, Dong M, Mahmoud M, lam Je, Pratap Jn, et al. Does intranasal dexmedetomidine provide adequate plasma concentrations for sedation in children: a pharmacokinetic study. Br J anaesth 2018;120:1056–65.

Yuen vM, Hui tW, irwin Mg, Yao tJ, Wong gl, Yuen MK. optimal timing for the administration of intranasal dex- medetomidine for premedication in children. anaesthesia 2010;65:922–9.

Miller JW, Divanovic aa, Hossain MM, Mahmoud Ma, Loepke AW. Dosing and efficacy of intranasal dexmedetomi- dine sedation for pediatric transthoracic echocardiography: a retrospective study. can J anaesth. 2016;63:834–41.




DOI: http://dx.doi.org/10.30633/jsm.v4i2.1183

Refbacks

  • There are currently no refbacks.





Publish by Stikes Syedza Saintika Padang 

Contact Person:

Ns. Honesty Diana Morika, M.kep
Editor In Chief
Pusat Penelitian dan Pengabdian Masyarakat
STIKes SYEDZA Saintika Padang

Jl. Prof. Dr. Hamka No. 228 Air Tawar Timur Padang - Sumatera Barat


Phone: 082384992512
Email: lppmsyedza@gmail.com


Google Schoolar