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

Mohanad Shukry, Mathison C. Clyde, Philip L. Kalarickal, Usha Ramadhyani

Research output: Contribution to journalArticle

145 Citations (Scopus)

Abstract

Background: 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.

Original languageEnglish (US)
Pages (from-to)1098-1104
Number of pages7
JournalPaediatric Anaesthesia
Volume15
Issue number12
DOIs
StatePublished - Dec 1 2005

Fingerprint

Dexmedetomidine
General Anesthesia
Incidence
Anesthesia
Pain
Pain Management
Trachea
Hypnotics and Sedatives
Inhalation
Analgesics
Hemodynamics
Placebos
Emergence Delirium
sevoflurane
Pharmaceutical Preparations

Keywords

  • Dexmedetomidine
  • Emergence delerium
  • Sevoflurane

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

Cite this

Does dexmedetomidine prevent emergence delirium in children after sevoflurane-based general anesthesia? / Shukry, Mohanad; Clyde, Mathison C.; Kalarickal, Philip L.; Ramadhyani, Usha.

In: Paediatric Anaesthesia, Vol. 15, No. 12, 01.12.2005, p. 1098-1104.

Research output: Contribution to journalArticle

Shukry, Mohanad ; Clyde, Mathison C. ; Kalarickal, Philip L. ; Ramadhyani, Usha. / Does dexmedetomidine prevent emergence delirium in children after sevoflurane-based general anesthesia?. In: Paediatric Anaesthesia. 2005 ; Vol. 15, No. 12. pp. 1098-1104.
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abstract = "Background: 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.",
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