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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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.
Authors: E H Jooste; W T Muhly; J W Ibinson; T Suresh; D Damian; A Phadke; P Callahan; S Miller; B Feingold; S E Lichtenstein; J G Cain; C Chrysostomou; P J Davis Journal: Anesth Analg Date: 2010-11-08 Impact factor: 5.108
Authors: Talal A Kayyal; Erik M Wolfswinkel; William M Weathers; Samantha J Capehart; Laura A Monson; Edward P Buchanan; Chris D Glover Journal: Craniomaxillofac Trauma Reconstr Date: 2014-02-28