Comparison of intubating conditions between dexmedetomidine and remifentanil when combined with sevoflurane-nitrous oxide for anesthesia induction in pediatric patients

Objective To compare the intubating conditions between dexmedetomidine and remifentanil when combined with sevoflurane-nitrous oxide (N2O) for anesthesia induction in the pediatric patients. Methods A total of 122 pediatric patients, aged 4-10 yr, of American Society of Anesthesiologists physical statusⅠ, undergoing elective plastic surgery, were randomly divided into dexmedetomidine group (group D, n=61) and remifentanil group (group R, n=61). Eight percent sevoflurane and 60% N2O were inhaled for induction of anesthesia, and the fresh gas flow was set at 6 L/min.After disappearance of eyelash reflex, dexmedetomidine 1 μg/kg and remifentanil 1 μg/kg were intravenously injected over 50-60 s in D and R groups, respectively, and 1 min later tracheal intubation was performed.The intubating conditions were graded, and the satisfactory intubating conditions and successful intubation were recorded.The development of adverse cardiovascular reactions and complications such as hyoxemia and laryngospasm before and after intubation and postoperative pharyngodynia was recorded. Results Compared with group D, no significant change was found in the success rate of intubation, rate of satisfactory intubation, intubating condition grade or incidence of postoperative pharyngodynia(P>0.05), and the incidence of hypertension and sinus tachycardia after intubation was significantly increased in group R (P<0.05). No pediatric patients developed hyoxemia, laryngospasm or sinus tachycardia in two groups. Conclusion When 8% sevoflurane and 60% N2O are inhaled for anesthesia induction, combing with dexmedetomidine 1 μg/kg produces better clinical efficacy than combing with remifentanil 1 μg/kg in improving the intubating conditions for pediatric patients. Key words: Dexmedetomidine; Piperidines; Anesthetics, inhalation; Intubation, intratracheal; Child