title: Postoperative respiratory and analgesic effects of dexmedetomidine or morphine for adenotonsillectomy in children with obstructive sleep apnoea.
abstract: The postoperative respiratory and analgesic effects of dexmedetomidine and morphine have not been compared in children with sleep apnoea having adenotonsillectomy. In a randomised double-blind study we recruited 60 children, aged 2-13 years, who received either intravenous dexmedetomidine 1 μg.kg(-1) or morphine 100 μg.kg(-1) on anaesthetic induction. End-tidal carbon dioxide, Children's Hospital of Eastern Ontario Pain Scale score and supplementary morphine administration were recorded every 15 min for 60 min postoperatively. Over 60 min, mean (SD) end-tidal carbon dioxide was consistently lower with dexmedetomidine compared with morphine (5.4 (0.7) kPa vs 6.0 (0.6) kPa, respectively; p = 0.001). Mean (SD) pain scores were higher with dexmedetomidine (8.1 (2.0) immediately postoperatively and 6.7 (1.0) at 60 min vs 7.6 (1.8) and 6.3 (0.7), respectively, with morphine (p = 0.023)). More patients required supplementary morphine with dexmedetomidine (13/30 (43%) vs 21/30 (70%); p = 0.037). Postoperatively, dexmedetomidine produced less respiratory depression than morphine, but less effective analgesia.
authors: Department of Anaesthesia, Children's Hospital of Fudan University, Shanghai, China.
authors: P J
authors: PJ
authors: Zhuang
authors: X
authors: X
authors: Wang
authors: X F
authors: XF
authors: Zhang
authors: Z J
authors: ZJ
authors: Zhou
authors: Q
authors: Q
authors: Wang
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D000700:Analgesics / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000009:adverse effects / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D009020:Morphine / Q000009:adverse effects / Q000494:pharmacology*; D012119:Respiration / Q000187:drug effects*; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology*; D014068:Tonsillectomy
chemical_list: D000700:Analgesics; D020927:Dexmedetomidine; D009020:Morphine