Related Experiment Video
Updated: Dec 18, 2025

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
Published on: June 2, 2022
The effect of dexmedetomidine on postoperative behaviour change in children: a randomised controlled trial
P F Lee-Archer1,2, B S von Ungern-Sternberg3,4, M Reade5
1Department of Anaesthesia, Queensland Children's Hospital, Brisbane, QLD, Australia.
Insights
Dexmedetomidine did not reduce negative behavior changes in children aged two to seven on postoperative day 3. However, intra-operative dexmedetomidine showed reduced negative behaviors by postoperative day 28.
Area of Science:
- Pediatric Anesthesiology
- Behavioral Science
Background:
- Children may exhibit behavioral changes post-general anesthesia, including tantrums, nightmares, and sleep/eating disorders.
- Assessing the impact of anesthetic agents on pediatric post-operative behavior is crucial for patient well-being.
Purpose of the Study:
- To investigate if dexmedetomidine administration (premedication or intra-operative) reduces negative behavioral changes in children aged 2-7 years after day case surgery.
- To compare the incidence of negative behaviors at different post-operative time points.
Main Methods:
- A randomized controlled trial involving 247 children aged 2-7 years undergoing day case surgery.
- Three groups were studied: intranasal dexmedetomidine premedication, intravenous dexmedetomidine intra-operatively, and a control group.
- Behavioral changes were assessed on postoperative days 3, 14, and 28 using the Post-Hospitalisation Behaviour Questionnaire for Ambulatory Surgery (PHBQ-AS) and the Strength and Difficulties Questionnaire (SDQ).
Main Results:
- No significant difference in negative behavior change was observed on postoperative day 3 between the three groups (PHBQ-AS: 47%, 44%, 51%; SDQ median scores: 7.5, 6.0, 8.0).
- A statistically significant reduction in negative behavior incidence was noted by postoperative day 28 in the intra-operative dexmedetomidine group (15%) compared to the premedication (36%) and control (41%) groups (p<0.001).
Conclusions:
- Dexmedetomidine does not appear to reduce immediate (postoperative day 3) negative behavioral sequelae in young children undergoing ambulatory surgery.
- Intra-operative administration of dexmedetomidine may offer a protective effect against longer-term negative behavioral changes up to postoperative day 28.
Abstract:
Children may develop changes in their behaviour following general anaesthesia. Some examples of negative behaviour include temper tantrums and nightmares, as well as sleep and eating disorders. The aim of this study was to determine whether dexmedetomidine reduces the incidence of negative behaviour change after anaesthesia for day case surgery in children aged two to seven years. Children were randomly allocated to one of three groups: a premedication group received 2 mg.kg-1 intranasal dexmedetomidine; an intra-operative group received 1 mg.kg-1 intravenous dexmedetomidine; and a control group. The primary outcome was the incidence of negative behaviour on postoperative day 3 using the Post-Hospitalisation Behaviour Questionnaire for Ambulatory Surgery (PHBQ-AS) and the Strength and Difficulties Questionnaire (SDQ). Secondary outcomes included: the incidence of negative behaviour on postoperative days 14 and 28; anxiety at induction; emergence delirium; pain; length of recovery and hospital stay; and any adverse events. The data for 247 patients were analysed. Negative behaviour change on postoperative day 3 was similar between all three groups when measured with the PHBQ-AS (47%, 44% and 51% respectively; adjusted p=0.99) and the SDQ (median scores 7.5, 6.0 and 8.0 respectively; adjusted p=0.99). The incidence of negative behaviour in the group who received dexmedetomidine intra-operatively was less at postoperative day 28 (15% compared with 36% in the dexmedetomidine premedication group and 41% in the control group, p<0.001). We conclude that dexmedetomidine does not reduce the incidence of negative behaviour on postoperative day 3 in two to seven-year olds having day case procedures.
Related Concept Videos
Parenteral Anesthetics: Overview
Stages of General Anesthesia
Drug Dosing: Infants and Children
Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Depolarizing Blockers: Pharmocokinetics
Skeletal Muscle Relaxants: Adverse Effects
Unlike...

