Intranasal deksmedetomidin er gunstig som premedikasjon til barn – sett fra anestesisykepleieres perspektiv
Sammanfattning
Background: Nasal administration of the drug dexmedetomidine is increasingly used for children who need sedation and premedication before anaesthesia and surgery. Midazolam, which currently is most widely used, is associated with a number of adverse effects. There is thus a need for alternative paediatric premedication to improve treatment provision.
Objective: To provide new knowledge on the properties of dexmedetomidine and how this drug is suited as premedication for children who will be given general anaesthesia, seen from the perspective of the anaesthetic nurse.
Method: We conducted semi-structured interviews. The sample consisted of six anaesthetic nurses from two day surgery units in two different hospitals. We analysed the data with the aid of qualitative content analysis.
Results: We identified two main topics: 1) Dexmedetomidine as premedication has favourable properties throughout the anaesthetic process. 2) Necessary precautions need to be taken throughout the anaesthetic process to ensure that no complications arise when dexmedetomidine is used as premedication. In general, the findings show that dexmedetomidine provides satisfactory sedation in the form of sleep preoperatively. It is found that the children are easy to wake up from their sedation. This means that the children need minimum exposure to stimulation before and during the induction of anaesthesia. However, the long onset time of dexmedetomidine necessitates interdisciplinary collaboration to achieve an efficient patient flow. The anaesthetic nurses did not describe any serious adverse effects of the drug.
Conclusion: New knowledge from the perspective of the anaesthetic nurses shows that dexmedetomidine is perceived as a suitable alternative to premedication for children. The disadvantages were described as minor when compared to the advantages provided by dexmedetomidine used as premedication, with favourable effects prior to, during and after surgery. The anaesthetic nurses faced some challenges in the use of dexmedetomidine at the start of the introduction process, but experience with the drug’s properties showed that to use it successfully and safely, necessary precautions must be taken throughout the anaesthetic process. The findings show that new procedures should be introduced by way of internal pilot projects.