title: Dexmedetomidine use during strabismus surgery in agitated children.
abstract: OBJECTIVE
  We aimed to investigate the effects of dexmedetomidine premedication before intravenous infusion of ketamine in agitated children undergoing strabismus surgery.
  
  
  METHODS
  We enrolled 60 agitated pediatric patients, aged 4.5-11 years. The patients were randomly allocated to one of two anesthesia regimens. Group D patients were premedicated with a single dose of intravenous dexmedetomidine 0.5 μg/kg whereas group P patients received a placebo. Patients in both groups were administered intravenous ketamine 1 mg/kg i.v. over 1 min followed by a continuous infusion of ketamine 1-3 mg/kg/h i.v. (n = 30). Patients were intubated after receiving fentanyl 1 μg/kg and rocuronium bromide 0.5 mg/kg.
  
  
  RESULTS
  21 (70%) patients in group D did not show the oculocardiac reflex (OCR) versus 7 (23%) in group P (p = 0.0006). The preoperative and postoperative agitation scores (p = 0.0001 and p = 0.03, respectively), the score on the Faces Pain Scale during awakening [3.0 (interquartile range, IQR 2.0-4.0) in group D and 0.0 (IQR 1.0-2.25) in group P] (p = 0.001) and at the 60th postoperative minute [IQR 2.0 (1.5-3.0) in group D and 2.0 (IQR 1.5-3.0) in group P] (p = 0.004), sore throat (26.6% in group D and 60% in group P) (p = 0.01) and analgesic requirement (20% in group D and 53% in group P) (p = 0.01) in group P were significantly higher than in group D. The Ramsay Sedation Score (RSS) in group D was significantly higher than in group P during awakening [2.0 (2.0-2.0) in group D and 4.5 (4.0-5.0) in group P] (p = 0.0001).
  
  
  CONCLUSIONS
  Dexmedetomidine premedication followed by intravenous infusion of ketamine was effective in decreasing OCR, agitation, pain, analgesic requirement in agitated children undergoing strabismus surgery.
authors.affiliation: Department of Anesthesiology and Reanimation, Gaziantep University School of Medicine, Gaziantep, Turkey. aysemizrak@hotmail.com
authors.forename: Ayse
authors.initials: A
authors.lastname: Mizrak
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Erbagci
authors.forename: Tulin
authors.initials: T
authors.lastname: Arici
authors.forename: Neslihan
authors.initials: N
authors.lastname: Avci
authors.forename: Suleyman
authors.initials: S
authors.lastname: Ganidagli
authors.forename: Unsal
authors.initials: U
authors.lastname: Oner
mesh_terms: D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D010147:Pain Measurement; D011184:Postoperative Period; D011292:Premedication / Q000379:methods; D011595:Psychomotor Agitation / Q000188:drug therapy*; D012024:Reflex, Oculocardiac; D018709:Statistics, Nonparametric; D013285:Strabismus / Q000601:surgery*
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine