Dexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery.
BACKGROUND
The purpose of the present study was to determine whether prophylactic use of 1 microg x kg(-1) dexmedetomidine affected the incidence of emergence agitation (EA) after sevoflurane based anesthesia without surgery in children.


METHODS
In a double-blinded trial, 42 children (ASA I-II,18 months to 10 years) undergoing magnetic resonance imaging (MRI) examination were randomly assigned to receive dexmedetomidine 1 microg x kg(-1) iv or placebo after induction of anesthesia. Heart rate (HR), mean arterial pressure (MAP), hemoglobin oxygen saturation (SpO2) were monitored. Anesthesia was induced in all patients, irrespective of group, with 8% sevoflurane in 50-50% O2/N2O and maintained with 1.5% sevoflurane in 50/50% O2/N2O. Agitation parameters were assessed with a 5-point scale and measured every 5 min. Delirium was defined as agitation score of > or =4 for > or =5 min. Anesthesia and procedure times and per- and postoperative side effects were recorded.


RESULTS
The HR, MAP, and SpO2, spontaneous arm or leg motion times and purposeful movement times showed no significant differences between the two groups. The time of removing the LMA, and the time of eye opening with verbal stimuli was shorter in group P than the group D (P = 0.007 and P = 0.01). The time of discharge to recovery room and the time of discharge from hospital were similar in the two groups. The mean agitation scores in the dexmedetomidine group were significantly lower than the placebo group except at 30 min (P < 0.0001, P = 0.001, P = 0.002, P = 0.013 and P = 0.001). The incidence of emergence agitation was 47.6% in group P, and 4.8% in group D (P = 0.002).


CONCLUSIONS
We concluded that a 1 microg x kg(-1) dose of i.v. dexmedetomidine reduces EA after sevoflurane anesthesia in children undergoing MRI.
Isik
Berrin
B
Department of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, Ankara, Turkey. berrinisik@gazi.edu.tr
Arslan
Mustafa
M
Tunga
Alper Dogan
AD
Kurtipek
Omer
O
D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003693:Delirium / Q000139:chemically induced / Q000453:epidemiology / Q000523:psychology; D020927:Dexmedetomidine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008738:Methyl Ethers; D010101:Oxygen Consumption / Q000187:drug effects; D011183:Postoperative Complications / Q000517:prevention & control* / Q000523:psychology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011595:Psychomotor Agitation / Q000517:prevention & control* / Q000523:psychology; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D020927:Dexmedetomidine