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

Cho, Hye‐Kyung; Yoon, Hyong Seo; Jin, Ho Jun; Hwang, Se Hwan

doi:10.1002/lary.26888

Cited by 15 publications

(23 citation statements)

References 37 publications

(102 reference statements)

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“…Adenotonsillectomy is one of the most commonly performed surgical procedures in childhood. However, the post‐operative period is exhausting for patients, and many suffer from post‐operative pain and agitation . Pain is more commonly felt during recovery after anaesthesia and may lead to reduced oral intake, dehydration and agitation.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent meta‐analysis, the effects of perioperative dexmedetomidine used an adjuvant during an adenotonsillectomy was compared with the use of opioid or placebo in paediatric patients who underwent adenotonsillectomy surgery . It was found that dexmedetomidine significantly lowered post‐operative pain and the need for analgesic drugs compared with the control group.…”

Section: Discussionmentioning

confidence: 99%

“…In turn, stress can exacerbate patient recoveries and cause adverse events. Therefore, effective pain control is important for diminishing post‐operative morbidity …”

Section: What Is Known and Objectivementioning

confidence: 99%

“…Therefore, effective pain control is important for diminishing post-operative morbidity. 2 Volatile anaesthetic agents commonly cause agitation in paediatric patients. Sevoflurane is the volatile agent most commonly used in children for inducing and maintaining general anaesthesia.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In turn, stress can exacerbate patient recoveries and cause adverse events. Therefore, effective pain control is important for diminishing post‐operative morbidity …”

Section: What Is Known and Objectivementioning

confidence: 99%

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

See 2 more Smart Citations

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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“…When compared to propofol sedation it also has been shown to be associated with lower rates of delirium [40]. In children dexmedetomidine significantly reduced delirium and agitation in the PACU stage following tonsillectomy [41,42]. This effect is probably due to its opioid sparing properties because opioids are one of the main precipitants of post-operative confusion states.…”

Section: Gastrointestinal Actionsmentioning

confidence: 99%

Is It Time for an Expanded Role of Dexmedetomidine in Contemporary Anesthesia Practice? - A Clinician's Perspective

Bohringer¹,

Liu²

2018

Transl Perioper & Pain Med

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Since its approval by US Food and Drug Administration in 1999 the clinical use of dexmedetomidine has been gaining in popularity. The indications and clinical applications of this drug have been expanded significantly. In this paper we reviewed its pharmacokinetics, pharmacodynamics, mechanisms of action and mainly focused on its clinical uses and outcomes.Common clinical uses of dexmedetomidine include pre-operative anxiolysis, heart rate control during intubation, treatment of bronchospasm, prevention of laryngospasm and avoiding opioid-induced post-operative respiratory depression and nausea and vomiting. Avoiding opioid induced respiratory depression has been especially beneficial in patients with sleep apnea syndrome. Other problems that can be prevented with dexmedetomidine are tachydysrhythmias, myocardial ischemia, delirium and acute kidney injury. Dexmedetomidine is an excellent sedative drug for intubated patients and it greatly facilitates neurological evaluation. It has been used successfully as a patient-controlled anesthesia drug and to prevent shivering. It is also used as an adjuvant to local anesthetics. It has been suggested that dexmedetomidine is a drug that has many beneficial effects and should be used more frequently by anesthesia care providers to prevent common problems in the peri-operative period. With judicious titration to effect during the intravenous administration of this drug the occurrence of side effects can be minimized. It is very likely that this drug will ascend to take a much more prominent role in future anesthesia practice.

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Update review of pain control methods of tonsil surgery

et al. 2020

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

Cited by 15 publications

References 37 publications

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

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

Is It Time for an Expanded Role of Dexmedetomidine in Contemporary Anesthesia Practice? - A Clinician's Perspective

Update review of pain control methods of tonsil surgery

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