To Compare the Dosage of Propofol Required at the Time of Induction with Nebulised Dexmedetomidine Vs Intranasal Dexmedetomidine

Abstract

Background

Dexmedetomidine, a highly selective α2-adrenergic receptor agonist, is widely used as a premedication due to its sedative, analgesic, and sympatholytic properties with minimal respiratory depression. Non-invasive routes such as intranasal and nebulized administration have gained increasing attention because of their ease of administration and favourable pharmacokinetic profiles. Premedication with dexmedetomidine has also been shown to reduce the requirement of induction agents such as propofol. However, limited data exist comparing the propofol-sparing effect of intranasal and nebulized dexmedetomidine.

Aim

To compare the dose of propofol required for induction of anaesthesia in patients premedicated with intranasal dexmedetomidine versus nebulized dexmedetomidine.

Materials and Methods

This prospective, randomized, double-blind comparative study included 60 adult patients aged 18–60 years belonging to ASA physical status I and II undergoing elective surgery under general anaesthesia. Patients were randomly allocated into two equal groups. Group IN received intranasal dexmedetomidine (1 µg/kg), while Group N received nebulized dexmedetomidine (1 µg/kg), administered 30–40 minutes before induction. Standard anaesthetic protocols were followed for all patients. Propofol was administered intravenously for induction until loss of verbal response and eyelash reflex. The total dose of propofol required for induction was recorded. Statistical analysis was performed using the unpaired t-test, and a p-value <0.05 was considered statistically significant.

Results

Patients receiving dexmedetomidine through both intranasal and nebulized routes required reduced doses of propofol for induction. The mean propofol requirement was lower in the nebulized dexmedetomidine group compared to the intranasal group, although the difference between the groups was not statistically significant (p > 0.05). Both routes provided adequate pre-induction sedation and facilitated smooth induction of anaesthesia.

Conclusion

Premedication with dexmedetomidine through both intranasal and nebulized routes effectively reduces the propofol requirement for induction of anaesthesia. The propofol-sparing effect was comparable between the two routes, suggesting that both intranasal and nebulized dexmedetomidine are effective non-invasive alternatives for premedication prior to induction of general anaesthesia.