Does dexmedetomidine prevent emergence delirium in children after sevoflurane‐based general anesthesia?

Paediatric Anaesthesia - Tập 15 Số 12 - Trang 1098-1104 - 2005
Mohanad Shukry1, MATHISON C. CLYDE1, Philip L. Kalarickal1, Usha Ramadhyani1
1Department of Anesthesiology, Tulane University, New Orleans, LA, USA.

Tóm tắt

SummaryBackground : Emergence agitation or delirium (ED) is a frequent phenomenon in children recovering from general anesthesia (GA). Dexmedetomidine, an alpha2 receptor agonist, has analgesic and sedative properties that might be helpful in the management of ED. We studied the effects of a continuous perioperative infusion of 0.2 μg·kg−1·h−1 dexmedetomidine on the incidence of ED in 50 children aged 1–10 years scheduled for sevoflurane‐based GA.Methods : Following inhalation induction of GA, the children were randomly assigned into dexmedetomidine or placebo Groups D and S, respectively. The infusion of 0.2 μg·kg−1·h−1 dexmedetomidine or equal volume of saline was started after securing the airway. Depth of anesthesia was maintained by adjusting the concentration of sevoflurane to achieve a Bispectral Index Score of 40–60. Intraoperative hemodynamics were recorded every 5 min and the trachea was extubated at the end of the procedure. Perioperative pain management was determined by the blinded anesthesia team, and the study drug infusion was maintained for 15 min following the postanesthesia care unit (PACU) admission. ED and pain scores were evaluated by a blinded observer.Results : The incidence of ED was statistically significantly different between the two groups, 26% in Group D Vs 60.8% in Group S (P = 0.036). Additionally, the number of episodes of ED was lower in Group D (P < 0.017). Pain scores and the times to extubate and discharge from PACU were the same.Conclusions : The perioperative infusion of 0.2 μg·kg−1·h−1 dexmedetomidine decreases the incidence and frequency of ED in children after sevoflurane‐based GA without prolonging the time to extubate or discharge.

Từ khóa


Tài liệu tham khảo

10.1046/j.1460-9592.2000.00560.x

10.1034/j.1399-6576.1999.430508.x

10.1046/j.1460-9592.1999.00351.x

10.1097/00000539-200205000-00023

10.1046/j.1460-9592.2002.00789.x

10.1097/00000539-200108000-00019

10.1213/01.ANE.0000094947.20838.8E

10.1213/00000539-199207000-00010

10.1097/00000542-198706000-00023

10.1097/00000542-199109001-00933

10.1007/BF03008224

10.1097/00000542-199712000-00006

10.1213/01.ANE.0000062522.21048.61

10.1097/00000542-199606000-00009

10.1097/00000539-199901000-00007

10.1097/00000542-200012000-00006

Dyck JB, 1993, Dexmedetomidine pharmacokinetics and pharmacodynamics, Anaesth Pharm Rev, 1, 238

10.1097/00000539-200003000-00035

10.1097/00000542-199705000-00008

10.1046/j.1460-9592.2002.00805.x

10.1097/00007611-200405000-00007

10.1093/bja/88.6.790

10.1016/S1053-0770(03)00200-3

10.1097/00000542-200405000-00015

10.1097/00000539-200105000-00016

10.1213/00000539-200004000-00018

10.1016/0304-3959(87)90033-9

Thông tin
Thông tin xuất bản

Paediatric Anaesthesia

Tập 15 Số 12

1098-1104

Thông tin tác giả