Comparing the Hemodynamic Effects of Nebulized Dexmedetomidine and Nebulized Lidocaine in Children undergoing Fiberoptic Bronchoscopy

Background & Objective: Several studies have shown that topical and intravenous Dexmedetomidine and Lidocaine can decrease pain and reduce consumption of analgesic drugs. However, Lidocaine may be accompanied with several side effects such as respiratory suppression, seizure, and cardiac arrhythmias. On the other hand, Dexmedetomidine has favorable properties such as low risk of apnea, analgesia, sympatholysis, and sedation. Therefore, the aim of this study was to compare the effects of nebulized Dexmedetomidine and nebulized Lidocaine on hemodynamic characteristics of the patients undergoing bronchoscopy. Materials & Methods: In the present randomized, double-blind study; 75 children (1-6 years old) undergoing fiber-optic bronchoscopy were allocated to three groups. Group 1 received nebulized solution containing 2 μg/kg of Dexmedetomidine. Group 2 received nebulized solution containing 4 mg/kg of Lidocaine 1%. Group 3 received nebulized solution containing 0.9% of normal saline as the control group. Heart rate, mean arterial blood pressure and SpO2, Bispectral Index (BIS) were measured and compared. BIS, indicating the depth of anesthesia was considered as a confounding factor. Statistical analysis was performed using SPSS 20. Results: The mean of arterial blood pressure and heart rate was significantly lower in group 1 compared to groups 2 and 3 during bronchoscopy (P<0.05). Blood oxygen saturation and sedation scores were significantly higher in group 1 compared to the other groups during bronchoscopy (P<0.05). Furthermore, the hemodynamic parameters were more stable in group 1 compared to the other groups during recovery. Conclusion: Premedication with nebulized Dexmedetomidine was significantly associated with more stable hemodynamic parameters and lower risk of side effects compared to nebulized Lidocaine in children undergoing fiberoptic bronchoscopy.