3 years ago

Effect of two different doses of dexmedetomidine on the incidence of emergence agitation after strabismus surgery: a randomized clinical trial

Khaled Abdel-baky Abdel-rahman, Sayed Kaoud Abd-elshafy, Jehan A. Sayed

Publication date: November–December 2018

Source: Brazilian Journal of Anesthesiology (English Edition), Volume 68, Issue 6

Author(s): Khaled Abdel-Baky Abdel-Rahman, Sayed Kaoud Abd-Elshafy, Jehan A. Sayed

Abstract
Background and objective

Emergence agitation is a postoperative negative behavior that affects mainly children. We studied the effect of two different doses of dexmedetomidine on the incidence and degree of EA in children undergoing strabismus surgery.

Methods

90 patients were allocated into three equal groups; patients received 0.5 μg.kg−1 of dexmedetomidine in high Dex group, 0.25 μg.kg−1 of dexmedetomidine in low Dex group, or normal saline in the placebo group. All drugs were received with the closure of the conjunctiva before the end of the surgery. Pediatric Anesthesia Emergence Delirium (PAED) scale was used to evaluate the agitation, and Face, Legs, Activity, Cry, Consolability (FLACC) scale was used for pain assessment. Adverse effects of dexmedetomidine and recovery times were recorded.

Results

The incidence of agitation was significantly lower in high Dex group compared to other groups and it was significantly lower in low Dex group compared to placebo group. The median (range) of FLACC score was significantly lower in both Dex groups compared to placebo group. Recovery times; time from removal of laryngeal mask to eye opening and time stay in post anesthesia care unit was significantly longer in high Dex group compared to other groups. No significant bradycardia or hypotension was recorded. Recovery time was significantly longer in high Dex group compared to the other two groups.

Conclusion

Dexmedetomidine (0.5 μg.kg−1) before emergence from general anesthesia resulted in a reduction in the incidence of emergence agitation compared to a dexmedetomidine (0.25 μg.kg−1) but on the expense of recovery times without adverse effects.

Resumo
Justificativa e objetivo

A agitação ao despertar é um comportamento pós-operatório negativo que afeta principalmente as crianças. Avaliamos o efeito de duas doses diferentes de dexmedetomidina na incidência e grau de agitação ao despertar em crianças submetidas à correção de estrabismo.

Métodos

Noventa pacientes foram alocados em três grupos iguais: receberam 0,5 μg.kg−1 de dexmedetomidina (grupo Dex-alta), 0,25 μg.kg−1 de dexmedetomidina (grupo Dex-baxia) ou solução salina normal (grupo placebo). Todos os medicamentos foram administrados com o fechamento da conjuntiva antes do fim da cirurgia. A escala pediátrica de delírio ao despertar da anestesia (PAED – Pediatric Anesthesia Emergence Delirium) foi usada para avaliar a agitação e a escala dos padrões de face, pernas, atividade, choro e consolabilidade (FLACC – Face, Legs, Activity, Cry, Consolability) foi usada para avaliar a dor. Os efeitos adversos de dexmedetomidina e os tempos de recuperação foram registrados.

Resultados

A incidência de agitação foi significativamente menor no grupo Dex-alta em comparação com os outros grupos, foi significativamente menor no grupo Dex-baxia em comparação com o grupo placebo. A mediana (variação) do escore FLACC foi significativamente menor em ambos os grupos Dex em comparação com o grupo placebo. O tempo de recuperação, o tempo transcorrido desde a remoção da máscara laríngea até a abertura dos olhos e o tempo de permanência na sala de recuperação pós-anestesia foram significativamente maiores no grupo Dex-alta em comparação com os outros grupos. Não houve registro de bradicardia ou hipotensão significativa. O tempo de recuperação foi significativamente maior no grupo Dex-alta em comparação com os outros dois grupos.

Conclusão

Dexmedetomidina (0,5 μg.kg−1) antes do despertar da anestesia geral resultou em uma redução da incidência de agitação ao despertar em comparação com dexmedetomidina (0,25 μg.kg−1), mas em detrimento dos tempos de recuperação sem efeitos adversos.

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.