title: Dexmedetomidine as a primary sedative agent after single-stage airway reconstruction.
abstract: OBJECTIVE
  To examine the outcomes of children receiving dexmedetomidine after single-stage airway reconstruction.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Tertiary care children's hospital.
  
  
  METHODS
  Of 61 eligible patients, 50 children undergoing single-stage airway reconstruction were included in the study. Thirty children received dexmedetomidine (Dex) as a primary sedative agent, and 20 received a more traditional sedation protocol (no Dex). Primary outcomes included complications, intubation lengths, and lengths of pediatric intensive care unit (PICU)/hospital admission. Secondary analysis incorporating polypharmacy and age was performed using multivariate linear regression models.
  
  
  RESULTS
  Median age was 18.0 months. Age, sex, and weight were similar between the groups. Intubation length was equal in the 2 groups, and there were no statistical differences between lengths of PICU or hospital stay after extubation. Similarly, overall and individual complications were all similar, and there was no difference between the 2 groups in the amount of polypharmacy administered. On multivariate analysis, polypharmacy and younger age were independently correlated with an increase in overall complications, and polypharmacy alone was correlated with an increased length of stay after extubation.
  
  
  CONCLUSIONS
  The use of dexmedetomidine as a primary sedation agent after single-stage airway surgery does not appear to improve outcomes or decrease the need for additional pharmacologic agents. Polypharmacy was associated with an increase in overall complications and an increased length of stay after extubation. Although success can be expected in greater than 90% of these surgical patients, the optimal postoperative sedation management remains challenging.
authors.affiliation: Division of Pediatric Otolaryngology, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. mmccormick@mcw.edu
authors.forename: Michael E
authors.initials: ME
authors.lastname: McCormick
authors.forename: Yewande J
authors.initials: YJ
authors.lastname: Johnson
authors.forename: Maria
authors.initials: M
authors.lastname: Pena
authors.forename: Angela T
authors.initials: AT
authors.lastname: Wratney
authors.forename: Sophie R
authors.initials: SR
authors.lastname: Pestieau
authors.forename: George H
authors.initials: GH
authors.lastname: Zalzal
authors.forename: Diego A
authors.initials: DA
authors.lastname: Preciado
mesh_terms: D000367:Age Factors; D060666:Airway Extubation; D015331:Cohort Studies; D020927:Dexmedetomidine; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D015278:Intensive Care Units, Pediatric; D058753:Laryngoplasty; D007829:Laryngostenosis / Q000601:surgery; D007902:Length of Stay; D008297:Male; D019338:Polypharmacy; D011183:Postoperative Complications; D012044:Regression Analysis; D014132:Trachea / Q000601:surgery*
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine