title: Low-dose dexmedetomidine reduces emergence agitation after desflurane anaesthesia in children undergoing strabismus surgery.
abstract: OBJECTIVE
  Emergence agitation (EA) is frequently observed in children undergoing general anaesthesia. This study tested whether the addition of an intra-operative low-dose infusion of dexmedetomidine to fentanyl treatment reduced the incidence of emergence delirium following desflurane anesthesia in children undergoing strabismus surgery.
  
  
  METHODS
  A total of 96 children (1-5 years old) undergoing strabismus surgery were enrolled. Anaesthesia was induced with propofol and maintained with desflurane. After induction, fentanyl (1 μg/kg) was administered to all children. During surgery, patients were infused with 0.2 μg/(kg·h)⁻¹ dexmedetomidine (Group FD, n=47) or normal saline (Group F, n=47). Postoperative objective pain score (OPS), Paediatric Agitation and Emergence Delirium (PAED) score, and EA score were documented every 10 minutes in the post-anaesthesia care unit.
  
  
  RESULTS
  There were no significant differences between the two groups in demographic characteristics and haemodynamic changes. The mean values of maximum EA, maximum PAED, and maximum OPS score were significantly lower in Group FD than in Group F at 0, 10, and 20 minutes after arrival at the post-anaesthesia care unit (p<0.001). The frequency of fentanyl rescue was lower in Group FD than in Group F (p<0.001). The incidence of severe EA was significantly lower in Group FD than in Group F (12.8% vs. 74.5%, p<0.001).
  
  
  CONCLUSIONS
  Intra-operative low-dose infusion of dexmedetomidine in addition to fentanyl reduces EA following desflurane anaesthesia in children undergoing strabismus surgeries.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. koobn@yuhs.ac.
authors.forename: Jeongmin
authors.initials: J
authors.lastname: Kim
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Kim
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Young Ran
authors.initials: YR
authors.lastname: Kang
authors.forename: Bon-Nyeo
authors.initials: BN
authors.lastname: Koo
mesh_terms: D017109:Akathisia, Drug-Induced / Q000517:prevention & control*; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects; D018685:Anesthetics, Inhalation / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D000077335:Desflurane; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D015742:Propofol / Q000627:therapeutic use; D012372:ROC Curve; D013285:Strabismus / Q000601:surgery*
chemical_list: D018685:Anesthetics, Inhalation; D020927:Dexmedetomidine; D000077335:Desflurane; D007530:Isoflurane; D005283:Fentanyl; D015742:Propofol
keywords: Dexmedetomidine; emergence agitation; objective pain score; pediatrics