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Low-Dose Dexmedetomidine Reduces Emergence Agitation after Desflurane Anaesthesia in Children Undergoing Strabismus Surgery

 Jeongmin Kim  ;  So Yeon Kim  ;  Jae Hoon Lee  ;  Young Ran Kang  ;  Bon-Nyeo Koo 
 YONSEI MEDICAL JOURNAL, Vol.55(2) : 508-516, 2014 
Journal Title
Issue Date
Akathisia, Drug-Induced/prevention & control* ; Anesthesia Recovery Period ; Anesthesia, General/adverse effects ; Anesthetics, Inhalation/adverse effects* ; Anesthetics, Inhalation/therapeutic use ; Child, Preschool ; Dexmedetomidine/administration & dosage* ; Dexmedetomidine/therapeutic use ; Female ; Fentanyl/therapeutic use ; Humans ; Infant ; Intraoperative Period ; Isoflurane/adverse effects ; Isoflurane/analogs & derivatives* ; Isoflurane/therapeutic use ; Male ; Ophthalmologic Surgical Procedures ; Propofol/therapeutic use ; ROC Curve ; Strabismus/surgery*
Dexmedetomidine ; emergence agitation ; objective pain score ; pediatrics
PURPOSE:Emergence agitation (EA) is frequently observed in children undergoing general anaesthesia. This study tested whether the addition of an intra-operative low-dose infusion of dexmedetomidine to fentanyl treatment reduced the incidence of emergence delirium following desflurane anesthesia in children undergoing strabismus surgery.
MATERIALS AND METHODS:A total of 96 children (1-5 years old) undergoing strabismus surgery were enrolled. Anaesthesia was induced with propofol and maintained with desflurane. After induction, fentanyl (1 μg/kg) was administered to all children. During surgery, patients were infused with 0.2 μg/(kg·h)⁻¹ dexmedetomidine (Group FD, n=47) or normal saline (Group F, n=47). Postoperative objective pain score (OPS), Paediatric Agitation and Emergence Delirium (PAED) score, and EA score were documented every 10 minutes in the post-anaesthesia care unit.
RESULTS:There were no significant differences between the two groups in demographic characteristics and haemodynamic changes. The mean values of maximum EA, maximum PAED, and maximum OPS score were significantly lower in Group FD than in Group F at 0, 10, and 20 minutes after arrival at the post-anaesthesia care unit (p<0.001). The frequency of fentanyl rescue was lower in Group FD than in Group F (p<0.001). The incidence of severe EA was significantly lower in Group FD than in Group F (12.8% vs. 74.5%, p<0.001).
CONCLUSION:Intra-operative low-dose infusion of dexmedetomidine in addition to fentanyl reduces EA following desflurane anaesthesia in children undergoing strabismus surgeries.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0001-6679-2782
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