ORIGINAL ARTICLE   

Minerva Pediatrics 2022 April;74(2):144-50

DOI: 10.23736/S2724-5276.17.04854-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The influence of dexmedetomidine on the emergence agitation of pediatric patients after the operations of sense organs under general anesthesia using sevoflurane

Xiao-Le WU, Bei PENG, Cheng-Jing SHAN, Jing-Jing LIU, Feng-Chao ZHANG ✉

Department of Anesthesiology, Xuzhou Children’s Hospital, Jiangsu, China

BACKGROUND: We investigated the influence of dexmedetomidine on the emergence agitation of pediatric patients after ophthalmologic operation under general anesthesia using sevoflurane.
METHODS: We selected 90 patients that were administered pediatric ophthalmologic operation for the study. The patients were randomly divided into 3 groups according to the administration way of drugs, i.e. the normal saline group (group S, N.=30), the midazolam group (group M, N.=30) and the dexmedetomidine group (group D, N.=30). For all patients, anesthesia induction was performed using sevoflurane before anesthesia, and the anesthesia was maintained in the operation with a combination of sevoflurane and remifentanil; laryngeal mask airway (LMA) was used for assisted ventilation. Ten minutes before the end of operation, 15 mL of 0.9% normal saline, 0.05 mg/kg of midazolam and 0.5 μg/kg of dexmedetomidine were administered to group S, group M and group D, respectively. After the operation, we observed the awakening time, time of the LMA removal as well as the recovery time in the Post Anesthesia Care Unit (PACU) of patients in all three groups. We evaluated the postoperative condition of sedation and agitation of the patients using Ramsay Sedation Scale, 5-point scale and Pediatric Anesthesia Emergence Deliriums Scale (PAED) and performed statistical analysis.
RESULTS: In the comparisons of awakening time, time of the LMA removal as well as the recovery time, we found that group M was the longest sequentially followed by group D and group S with statistically significant differences (P<0.05). While the comparison of the scores of Ramsay Sedation Scale revealed that group D scored highest followed by group M and group S with statistically significant differences (P<0.05), both of the comparisons of the scores of 5-point scale and PAED Scale showed that group D scored the lowest, followed by group M and group S in sequence with statistically significant differences (P<0.05).
CONCLUSIONS: Dexmedetomidine can significantly lower the incidence of emergence agitation of pediatric patients after the ophthalmologic operation under sevoflurane anesthesia.

KEY WORDS: Sense organs; Dexmedetomidine; Emergence delirium; Child