Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial

Sato, Aiji; Hanamoto, Hiroshi; Oyamaguchi, Aiko; Inoue, Mika; Morimoto, Yoshinari; Niwa, Hitoshi

doi:10.1016/j.bjane.2015.01.001

Cited by 13 publications

(14 citation statements)

References 33 publications

(31 reference statements)

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“…Confirming the previous trials,[1171819] this trial emphasized that dexmedetomidine markedly decreases the incidence of EA and curtail its severity in children after sevoflurane anesthesia without complications and with smooth postoperative recovery course.…”

Section: Discussionsupporting

confidence: 82%

Effect of intranasal dexmedetomidine on emergence agitation after sevoflurane anesthesia in children undergoing tonsillectomy and/or adenoidectomy

El-Hamid

Yassin

2017

Saudi J Anaesth

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Background:Emergence agitation (EA) after sevoflurane anesthesia is common in children during recovery from general anesthesia and may result in postoperative complications. This study investigated safety and effectiveness of intranasal dexmedetomidine in reducing the incidence and severity of EA.Methods:This prospective, randomized double-blinded controlled trial included 86 patients scheduled for the tonsillectomy and/or adenoidectomy under general anesthesia with sevoflurane. They were randomly allocated into two groups. Group D received intranasal dexmedetomidine at 1 μg/kg, and Group C received intranasal saline 0.9% after the induction of general anesthesia. Four-point agitation scale and Face, Legs, Activity, Cry and Consolability (FLACC) scale for pain assessment were measured at six time points (after extubation, leaving the operating room, on arrival to postanesthesia care unit [PACU], 10, 20, and 30 min after arrival in PACU). Extubation, emergence, and discharge times were recorded in addition to any adverse effects.Results:There was a significant difference in the incidence of EA between Groups D and C (6.98% and 58%, respectively, with P = 0.001). The median four-point agitation scales and the median scores of FLACC pain scales of Group D were significantly lower than those of Group C at the all six time points with P < 0.05. Extubation, emergence, and discharge times were comparable in both groups, and none of the subjects reported any adverse effects.Conclusion:This study demonstrates that a 1 μg/kg dose of intranasal dexmedetomidine administered after the induction of anesthesia reduces post-sevoflurane incidence and severity of EA in children undergone tonsillectomy and/or adenoidectomy with no adverse effects and smooth recovery profile.

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Section: Discussionsupporting

confidence: 82%

Effect of intranasal dexmedetomidine on emergence agitation after sevoflurane anesthesia in children undergoing tonsillectomy and/or adenoidectomy

El-Hamid

Yassin

2017

Saudi J Anaesth

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“…Boku and colleagues found similar results in 70 infants aged 10 to 14 months undergoing cleft palate surgery, where infants either received dexmedetomidine or saline during sevoflurane anesthesia. Based on an anesthesiologist's score of emergence agitation and pain, agitation and pain were found to be significantly lower in children who were given dexmedetomidine as compared to those given saline (Boku et al, 2016 (Lehmkuhl et al, 1987). Similar results were found in a group of middle-aged adults who received isoflurane and fentanyl anesthesia during abdominal surgery.…”

Section: Negative Postoperative Behavioural Changessupporting

confidence: 53%

0934 Evaluating the Effects of General Anesthesia on Sleep in Children Undergoing Elective Surgery

Selvadurai

Maynes

McDonnell

et al. 2017

Sleep

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“…Prophylactic pharmaceutical interventions such as α 2 -agonist [5][6][7], µ-opioid agonists [8][9], and propofol [10] are effective for preventing EA. Dexmedetomidine, a selective α 2 -adrenoceptor agonist, significantly reduced the incidence of EA in children [11,12].…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Co-administration of sufentanil and dexmedetomidine prevents emergence agitation in pediatric patients

Hou¹,

Bi²,

Cui³

et al. 2018

Oncotarget

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We compared the effectiveness of dexmedetomidine alone and combined with sufentanil for preventing emergence agitation in children under sevoflurane anesthesia. Eighty children scheduled for tonsillectomy or adenotonsillectomy under sevoflurane anesthesia were randomized into four groups: control, dexmedetomidine, dexmedetomidine with 0.1 μg/kg sufentanil (Dex+Suf1), and dexmedetomidine with 0.2 μg/kg sufentanil (Dex+Suf2). The incidence and severity of emergence agitation was evaluated based on Aono's scale and the pediatric anesthesia emergence delirium scale. The incidence of agitation was 45% in the control group, 20% in the dexmedetomidine group, 5% in Dex+Suf1 group, and 0% in Dex+Suf2 group. The Aono's and pediatric anesthesia emergence delirium scores in the Dex+Suf1 and Dex+Suf2 groups were lower than in the control or dexmedetomidine group during the tracheal extubation (P < 0.05). In the Dex+Suf1 and Dex+Suf2 groups, the time of tracheal extubation was longer than in the control or dexmedetomidine group (P < 0.05). The Dex+Suf2 group had longer tracheal extubation and awaken times than the other groups (P < 0.05). Thus dexmedetomidine with 0.1 μg/kg sufentanil was the optimal dose combination that reduced emergence agitation without prolonging awaken time.

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Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial

Abstract: Dex administration has the advantage of a reduced EA and PS without any adverse effects. Dex provided satisfactory recovery in infants undergoing palatoplasty.

Cited by 13 publications

References 33 publications

Effect of intranasal dexmedetomidine on emergence agitation after sevoflurane anesthesia in children undergoing tonsillectomy and/or adenoidectomy

Effect of intranasal dexmedetomidine on emergence agitation after sevoflurane anesthesia in children undergoing tonsillectomy and/or adenoidectomy

0934 Evaluating the Effects of General Anesthesia on Sleep in Children Undergoing Elective Surgery

WITHDRAWN: Co-administration of sufentanil and dexmedetomidine prevents emergence agitation in pediatric patients

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