Investigating the Effect of Dexmedetomidine in Controlling Postoperative Emergence Agitation in Children under Sevoflurane Anesthesia.

IF 1.6 Q2 ANESTHESIOLOGY
Anesthesiology Research and Practice Pub Date : 2024-07-24 eCollection Date: 2024-01-01 DOI:10.1155/2024/6418429
Mitra Golmohammadi, Shahryar Sane, Somayeh Ghavipanjeh Rezaei, Rana Hosseini, Enas R Alwaily, Beneen M Hussien, Ramin Mohammadpour, Nazila Rahmani, Behzad Kazemi Haki
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Abstract

Introduction: Emergence agitation (EA) is one of the common problems during recovery from general anesthesia, especially in children. In this study, we investigated the effect of dexmedetomidine on the control of agitation after anesthesia with sevoflurane in children.

Method: This randomized control-placebo, double-blind prospective clinical trial was conducted on seventy-six children between 2 and 7 years with ASA (American Society of Anesthesiologists) class I who were candidates for elective adenoidectomy surgery and tonsillectomy. Participants were selected by an available sampling method. Patients were randomly placed in one of the two groups D (dexmedetomidine 0.5 μg/kg infusion within ten minutes) or P (placebo: normal saline infusion within ten minutes). A four-point scale evaluated agitation. Pain evaluation was done by FLACC (faces, legs, activity, cry, and consolability). The statistical software was SPSS version 23. P < 0.05 was considered statistically significant.

Results: The level of agitation was significantly lower in the intervention group (P < 0.05), except after 40 minutes in the PACU (Post Anesthesia Care Unit) (P=1.00). Patients in the control group experienced high pain scores when admitted at PACU, 10, 20, and 30 minutes after admission at PACU (P < 0.05). Pethidine and metoclopramide prescriptions in the intervention group were lower than in the control group (P < 0.05). Shivering occurred in five patients in the intervention group and nine in the control groups (P=0.032). Hypotension that required intervention occurred in 3 patients in the intervention group and one in the control group (P=0.024).

Conclusion: Our trial demonstrated that the prescription of 0.5 μg/kg of dexmedetomidine within ten minutes after intubation significantly reduced the EA frequency, pain severity, analgesic consumption, and PONV (postoperative nausea and vomiting). However, it caused delays in the emergence from anesthesia. This trial is registered with IRCT20160430027677N14.

研究右美托咪定对控制七氟醚麻醉下儿童术后躁动的影响
前言出院后躁动(EA)是全身麻醉恢复期的常见问题之一,尤其是在儿童中。本研究探讨了右美托咪定对控制儿童七氟醚麻醉后躁动的影响:这项随机对照-安慰剂双盲前瞻性临床试验的对象是 76 名年龄在 2 到 7 岁之间、ASA(美国麻醉医师协会)Ⅰ级的儿童,他们都是选择性腺样体切除手术和扁桃体切除术的候选者。参与者是通过现有的抽样方法选出的。患者被随机分为 D 组(在十分钟内输注右美托咪定 0.5 μg/kg)或 P 组(安慰剂:在十分钟内输注生理盐水)。躁动采用四级评分法进行评估。疼痛评估采用 FLACC(脸部、腿部、活动、哭泣和可安慰性)。统计软件为 SPSS 23 版本。P<0.05为差异有统计学意义:结果:干预组患者的躁动程度明显降低(P < 0.05),但在 PACU(麻醉后护理病房)40 分钟后除外(P=1.00)。对照组患者在进入 PACU、进入 PACU 10 分钟、20 分钟和 30 分钟后疼痛评分较高(P < 0.05)。干预组的哌替啶和甲氧氯普胺处方量低于对照组(P < 0.05)。干预组有 5 名患者出现颤抖,对照组有 9 名(P=0.032)。需要干预的低血压发生率为干预组 3 例,对照组 1 例(P=0.024):我们的试验表明,在插管后十分钟内处方 0.5 μg/kg 右美托咪定可显著减少 EA 频率、疼痛严重程度、镇痛药用量和 PONV(术后恶心和呕吐)。然而,它却会导致麻醉后苏醒的延迟。该试验的注册号为 IRCT20160430027677N14。
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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
29
审稿时长
18 weeks
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