Effect of fixed-dose intravenous dexmedetomidine on emergence delirium after general anesthesia for a surgery in pediatric patients - A randomized controlled trial.

Abstract

Background: Emergence delirium (ED) in pediatric patients can result in bodily harms, maladaptive changes, and longer post-anesthesia care unit (PACU) stays. The incidence of ED varies in pediatric patients depending on various factors such as age, type of anesthesia, type of surgery, pain, and the choice of diagnostic tools. Various pharmacological and non-pharmacological methods have been used to reduce its incidence postoperatively. This study aims to investigate the role of a fixed dose of intravenous dexmedetomidine in preventing ED in pediatric patients.

Methods: Approval from the institutional ethical committee was obtained for this randomized controlled trial. Inclusion criteria included pediatric patients aged between 2 and 12 years, with ASA scores ranging from 1 to 3, who were scheduled to undergo general anesthesia for a surgical procedure. The intervention group received 20 ml of 0.2 mcg/kg dexmedetomidine intravenously over a period of 20 minutes before the end of the operation. In contrast, the control group received 20 ml of 0.9% saline. The primary outcome measure of this study was the incidence of ED in the PACU. All data collected during the study were entered and analyzed using the SPSS 22.0 statistical package program.

Results: A total of 66 patients were included in the study. All baseline characteristics of both groups were similar. The incidence of ED in the control group was 42% (14/33), whereas it was 15% (5/33) in the dexmedetomidine group (p = 0.014).

Conclusion: The use of 0.2 mcg/kg intravenous dexmedetomidine reduces the incidence of ED in patients undergoing general anesthesia with sevoflurane.