Analysis of the clinical effect of dexmedetomidine hydrochloride for sedation before cosmetic suturing of emergency facial trauma in children

Objective To explore the clinical efficacy and safety of dexmedetomidine hydrochloride for preoperative sedation in children undergoing emergency facial trauma cosmetic suturing. Methods A total of 200 children with facial trauma admitted to the Emergency Surgery Department of our hospital from January to June 2025 were retrospectively enrolled and assigned to two groups for different sedation interventions. The study group received preoperative intranasal dexmedetomidine hydrochloride spray, while the control group received routine comfort care. The UMSS Sedation Scale was used to assess sedation level objectively, and rescue dosing protocols were implemented for sedation failure. Statistical analyses were performed using SPSS 30.0 software, with a two-tailed P -value ≤ 0.05 and 95% confidence intervals (CIs) considered statistically significant. Results A total of 100 cases were included in both the study group and the control group, with no baseline differences between the two groups ( P > 0.05). The sedation failure rate in the study group was 8.0% (8/100), and all 8 cases achieved effective sedation after rescue dosing with one additional spray (15 μ g for 10.7–19.4 kg, 25 μg for 19.4–28.0 kg) intranasal dexmedetomidine hydrochloride; no sedation failure was observed in the control group. No serious adverse reactions were observed in either group. Preoperative and intraoperative cooperation in the study group was significantly better than that in the control group, and the incidence of agitation was significantly lower ( P < 0.01), 95%CI: 0.0–0.2. No serious adverse reactions were observed in either group. Preoperative heart rate, respiratory rate, oxygen saturation, and mean arterial pressure were comparable between the two groups ( P > 0.05). Intraoperatively, the study group maintained more stable vital signs, with significantly lower heart rate and mean arterial pressure than the control group ( P < 0.05), 95%CI for heart rate: 8.2–15.7; 95%CI for mean arterial pressure: 5.1–10.3, all within normal physiological ranges. Conclusion Preoperative intranasal dexmedetomidine hydrochloride is an effective and safe regimen for improving intraoperative cooperation, stabilizing vital signs, reducing agitation, and enhancing cosmetic suture quality and family satisfaction in children with emergency facial trauma.