Single-dose dexmedetomidine reduces agitation and provides smooth extubation after pediatric adenotonsillectomy.
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.
Guler
Gulen
G
Department of Anesthesiology, Erciyes University, Medical Faculty, Kayseri, Turkey. gulen@erciyes.edu.tr
Akin
Aynur
A
Tosun
Zeynep
Z
Ors
Sevgi
S
Esmaoglu
Aliye
A
Boyaci
Adem
A
D000233:Adenoidectomy; D000769:Anesthesia, Inhalation; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007442:Intubation, Intratracheal; D008297:Male; D010147:Pain Measurement; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000523:psychology; D014068:Tonsillectomy
D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine