Single-dose dexmedetomidine reduces agitation and provides smooth extubation
after pediatric adenotonsillectomy.
Author(s): Guler G(1), Akin A, Tosun Z, Ors S, Esmaoglu A, Boyaci A.
Affiliation(s): Author information:
(1)Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri,
Turkey. gulen@erciyes.edu.tr
Publication date & source: 2005, Paediatr Anaesth. , 15(9):762-6
BACKGROUND: Dexmedetomidine has shown sedative, analgesic, and anxiolytic effects
after intravenous (IV) administration. Sevoflurane is associated with a high
incidence of emergence agitation in preschool children. In this
placebo-controlled study, we examined the effect of single dose dexmedetomidine
on emergence agitation in children undergoing adenotonsillectomy.
METHODS: In a double-blinded trial, 60 children (age 3-7 years) were randomly
assigned to receive dexmedetomidine 0.5 microg.kg(-1) IV or placebo, 5 min before
the end of surgery. All patients received a standardized anesthetic regimen. For
induction and maintenance of anesthesia we used sevoflurane. After surgery, the
incidence and severity of agitation was measured 2 h postoperatively. The
incidence of untoward airway events after extubation, such as breath holding,
severe coughing, or straining were recorded. After surgery, the children's
behavior and pain were assessed with a 5-point scale.
RESULTS: The agitation and pain scores in the dexmedetomidine group were better
than those in the placebo group (P < 0.05). The incidence of severe agitation (a
score of 4 or more), and severe pain (a score of 3 or more) were significantly
less in the dexmedetomidine group (P < 0.05). The number of severe coughs per
patient in the dexmedetomidine group was significantly decreased compared with
the control group (P < 0.05). Postoperative vomiting was similar in both groups.
Times to emergence and extubation were significantly longer in the
dexmedetomidine group (P < 0.05).
CONCLUSIONS: We conclude that 0.5 microg.kg(-1) dexmedetomidine reduces agitation
after sevoflurane anesthesia in children undergoing adenotonsillectomy.
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