title: Effect of dexmedetomidine on sevoflurane requirements and emergence agitation in children undergoing ambulatory surgery.
abstract: OBJECTIVE
  Dexmedetomidine, a potent selective α2-adrenergic agonist, produces sedation and analgesia. This study was conducted to assess the effect of dexmedetomidine infusion on sevoflurane requirements, recovery profiles, and emergence agitation in children undergoing ambulatory surgery.
  
  
  METHODS
  Forty children undergoing ambulatory hernioplasty or orchiopexy were randomized into two groups. The dexmedetomidine group (Group D, n=20) received dexmedetomidine 1 μg/kg, followed by 0.1 μg/kg/h until the end of surgery, whereas the saline group (Group S, n=20) received volume-matched normal saline. Sevoflurane was used for induction and maintenance of anesthesia and caudal block was performed in all children. End-tidal sevoflurane concentration (ET-sevo), the incidence of emergence agitation, pain scores, and sedation scores were recorded. Hemodynamic changes and other adverse effects were assessed in the perioperative period.
  
  
  RESULTS
  ET-sevo of Group D was significantly reduced in 23.8-67% compared to Group S during surgery. The incidence of emergence agitation was lower in Group D than in Group S (5% vs. 55%, p=0.001). Postoperative pain was comparable, and discharge time was not different between the groups. Mean arterial pressure and heart rate were significantly lower in Group D during surgery.
  
  
  CONCLUSIONS
  Intraoperative infusion of dexmedetomidine reduced sevoflurane requirements and decreased emergence agitation without delaying discharge in children undergoing ambulatory surgery. However, caution should be taken in regard to bradycardia and hypotension.
authors: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. hkkil@yuhs.ac.
authors: Na Young
authors: NY
authors: Kim
authors: So Yeon
authors: SY
authors: Kim
authors: Hye Jin
authors: HJ
authors: Yoon
authors: Hae Keum
authors: HK
authors: Kil
mesh_terms: D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002648:Child; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000188:drug therapy; D000077149:Sevoflurane; D055815:Young Adult
chemical_list: D008738:Methyl Ethers; D000077149:Sevoflurane; D020927:Dexmedetomidine
keywords: Agitation; ambulatory surgery; dexmedetomidine; emergence; sevoflurane