title: Dexmedetomidine decreases emergence agitation in pediatric patients after sevoflurane anesthesia without surgery.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, Ankara, Turkey. berrinisik@gazi.edu.tr
authors.forename: Berrin
authors.initials: B
authors.lastname: Isik
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arslan
authors.forename: Alper Dogan
authors.initials: AD
authors.lastname: Tunga
authors.forename: Omer
authors.initials: O
authors.lastname: Kurtipek
mesh_terms: 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
chemical_list: D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D020927:Dexmedetomidine