Dexmedetomidine as a Rapid Bolus for Treatment and Prophylactic Prevention of Emergence Agitation in Anesthetized Children

Hauber, John A.; Davis, Peter J.; Bendel, Laima P.; Martyn, Slava V.; McCarthy, Denise L.; Evans, Minh-Chau; Cladis, Franklyn P.; Cunningham, Sarah; Lang, Robert Scott; Campbell, Neal F.; Tuchman, Jay B.; Young, Michael C.

doi:10.1097/01.sa.0000484837.28884.17

Cited by 23 publications

(45 citation statements)

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“…Dexmedetomidine is a highly selective a2adrenoceptor agonist with sedative, analgesic, and anxiolytic actions without respiratory depression, and it has been widely used in various clinical situations. 8 Dexmedetomidine appears to be effective in a wide range of doses 10 and is reported to have a short half-life, about 1.8 hours. 32,35 Based on these characteristics, dexmedetomidine could be considered a useful analgesic and sedative option for children who undergo adenotonsillectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Outcomes for analysis were postoperative pain (pain scores) in the postanesthesia care unit (PACU), [10][11][12][13][14][15][16][17][18] postoperative analgesic requirements (doses of postoperative opioids or nonopioid analgesics), 4,8,[10][11][12]16,17,[19][20][21][22][23][24][25][26][27][28][29][30] postoperative agitation (agitation scores and incidence during recovery), 8,10,11,13,[15][16][17][18][19][21][22][23]31 desaturation, 8,10,15,17,18,20,24 and residual sedation (time to discharge from PACU). 8,…”

Section: Data Extraction and Risk Of Bias Assessmentmentioning

confidence: 99%

“…6,7 During the past few years, dexmedetomidine has reportedly been used in pediatrics as a premedication, a sedation agent used in pediatric intensive care units, an adjunct to inhaled anesthetic agents, and a drug for both prophylaxis and treatment of EA after general anesthesia. 8 The results of several recent studies on the use of perioperative adjuvant dexmedetomidine are encouraging, showing beneficial effects on postoperative morbidities such as pain and agitation in pediatric patients. 9 However, evidence in the existing literature is insufficient to fully support the use of dexmedetomidine in posttonsillectomy events in children.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of dexmedetomidine for perioperative morbidities in pediatric tonsillectomy: A metaanalysis

Cho¹,

Yoon

Jin

et al. 2017

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

Section: Data Extraction and Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of dexmedetomidine for perioperative morbidities in pediatric tonsillectomy: A metaanalysis

Cho¹,

Yoon

Jin

et al. 2017

The Laryngoscope

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“…Dexmedetomidine, a sedative which acts as an alpha2-agonist, is already being widely used in the clinical setting by pediatric anesthesiologists and intensivists. While it is not yet FDA approved for use in pediatrics, its safety in this context has been well documented in the literature [8][9][10][11].…”

Section: T-rex (Toxicity Of Remifentanil -Dexmedetomidine) Trialmentioning

confidence: 99%

Summary of the Update Session on Clinical Neurotoxicity Studies

Pinyavat¹,

Warner²,

Flick

et al. 2016

Journal of Neurosurgical Anesthesiology

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During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study. The purpose of this summary is to discuss the contributions and limitations of these studies, how they fit into the published literature, and what questions remain to be answered.

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“…2,16 It has also been demonstrated that dexmedetomidine decreases post-operative pain and agitation. 17 For these reasons, dexmedetomidine may be effectively used to treat post-operative pain and agitation in children undergoing adenotonsillectomy surgery using sevoflurane.…”

Section: Ta B L E 1 Comparison Of Baseline Characteristics Of Patientmentioning

confidence: 99%

The effects of dexmedetomidine and tramadol on post‐operative pain and agitation, and extubation quality in paediatric patients undergoing adenotonsillectomy surgery: A randomized trial

et al. 2019

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What is known and objective Adenotonsillectomies are common surgical procedures performed under general anaesthesia in childhood. Post‐operative pain and agitation are complications associated with this procedure. We compared the effects of dexmedetomidine and tramadol on post‐operative pain, agitation, haemodynamic parameters, and extubation quality in patients undergoing an adenotonsillectomy using sevoflurane as an anaesthetic agent. Methods Sixty paediatric patients who had undergone an adenotonsillectomy were included in this study. The patients were randomized into two groups that received either dexmedetomidine (n = 30) or tramadol (n = 30). Haemodynamic variables, extubation time, post‐operative pain, agitation and adverse events were recorded for all patients. Post‐operative pain was assessed with the pain point system scale (PPSS), and agitation was assessed using the Riker Sedation‐Agitation Scale (SAS). Results Patients in the dexmedetomidine group had significantly lower heart rates than the tramadol group. In addition, patients in the dexmedetomidine group had significantly lower post‐operative PPSS and Riker SAS scores than patients in the tramadol group. Not breathing, cough‐bucking and desaturation after extubation occurred less frequently in patients who received dexmedetomidine than in patients who received tramadol. However, the time to extubation was significantly longer for patients who received dexmedetomidine. What is new and conclusion Our study demonstrated that dexmedetomidine was more effective than tramadol for mitigating post‐operative pain and agitation in paediatric patients following an adenotonsillectomy with sevoflurane. Although dexmedetomidine was associated with a longer time to extubation, it was also associated with fewer complications following extubation compared with tramadol.

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Dexmedetomidine as a Rapid Bolus for Treatment and Prophylactic Prevention of Emergence Agitation in Anesthetized Children

Cited by 23 publications

References 0 publications

Efficacy of dexmedetomidine for perioperative morbidities in pediatric tonsillectomy: A metaanalysis

Efficacy of dexmedetomidine for perioperative morbidities in pediatric tonsillectomy: A metaanalysis

Summary of the Update Session on Clinical Neurotoxicity Studies

The effects of dexmedetomidine and tramadol on post‐operative pain and agitation, and extubation quality in paediatric patients undergoing adenotonsillectomy surgery: A randomized trial

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