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Low-dose dexmedetomidine reduces emergence agitation after desflurane anaesthesia in children undergoing strabismus

Jeongmin Kim1, So Yeon Kim, Jae Hoon Lee

  • 1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. koobn@yuhs.ac.

Yonsei Medical Journal
|February 18, 2014
PubMed

Insights

Adding low-dose dexmedetomidine to fentanyl effectively reduced emergence agitation (EA) in children after desflurane anesthesia for strabismus surgery. This combination therapy significantly lowered EA, PAED scores, and pain, improving patient recovery.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Surgical Recovery

Background:

  • Emergence agitation (EA) is a common complication in children post-general anesthesia.
  • Desflurane anesthesia is frequently used for pediatric strabismus surgery.
  • Effective management of EA is crucial for optimal postoperative care.

Purpose of the Study:

  • To evaluate the efficacy of intra-operative low-dose dexmedetomidine combined with fentanyl in reducing emergence agitation.
  • To compare the incidence and severity of EA in children receiving dexmedetomidine plus fentanyl versus fentanyl alone.
  • To assess the impact on pain scores and need for rescue analgesia.

Main Methods:

  • A randomized controlled trial involving 96 children (1-5 years) undergoing strabismus surgery.
  • Anesthesia maintained with desflurane, with fentanyl administered to all participants.
  • Intervention group received intra-operative dexmedetomidine infusion (0.2 μg/kg/h); control group received normal saline.
  • Postoperative emergence agitation (EA), Paediatric Agitation and Emergence Delirium (PAED) scores, and objective pain scores (OPS) were recorded.

Main Results:

  • No significant demographic or hemodynamic differences between groups.
  • Significantly lower maximum EA, PAED, and OPS scores in the dexmedetomidine group (Group FD) compared to the fentanyl-only group (Group F).
  • Incidence of severe EA was markedly reduced in Group FD (12.8% vs. 74.5%, p<0.001).
  • Lower frequency of fentanyl rescue in Group FD (p<0.001).

Conclusions:

  • Intra-operative low-dose dexmedetomidine, when added to fentanyl, significantly reduces emergence agitation.
  • This combination therapy improves postoperative recovery and pain management in pediatric strabismus surgery.
  • Dexmedetomidine is a valuable adjunct for mitigating EA following desflurane anesthesia in this population.
Abstract

Keywords:
Dexmedetomidineemergence agitationobjective pain scorepediatrics

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