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

Mitra Golmohammadi1, Shahryar Sane1, Somayeh Ghavipanjeh Rezaei2

  • 1Department of Anesthesiology Urmia University of Medical Sciences, Urmia, Iran.

Anesthesiology Research and Practice
|August 6, 2024
PubMed

Insights

Dexmedetomidine significantly reduced emergence agitation (EA) and pain in children after anesthesia. However, it may delay emergence from anesthesia, requiring careful consideration of its use.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Emergence agitation (EA) is a common complication following general anesthesia in children.
  • Sevoflurane anesthesia is frequently used in pediatric procedures, but can be associated with EA.

Purpose of the Study:

  • To investigate the efficacy of dexmedetomidine in controlling emergence agitation in children.
  • To assess the impact of dexmedetomidine on pain, analgesic consumption, and side effects during emergence from sevoflurane anesthesia.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial involving 76 children aged 2-7 years undergoing elective adenoidectomy/tonsillectomy.
  • Patients received either dexmedetomidine (0.5 μg/kg) or placebo (normal saline) infusion ten minutes after intubation.
  • Agitation was assessed using a four-point scale, and pain was evaluated with the FLACC scale.

Main Results:

  • Dexmedetomidine significantly reduced agitation and pain scores in the Post Anesthesia Care Unit (PACU), except at 40 minutes post-PACU admission.
  • Analgesic (pethidine) and antiemetic (metoclopramide) use was lower in the dexmedetomidine group.
  • Increased incidence of shivering and hypotension requiring intervention was observed in the dexmedetomidine group compared to placebo.

Conclusions:

  • A perioperative infusion of 0.5 μg/kg dexmedetomidine effectively reduces emergence agitation, pain, and postoperative nausea and vomiting in children.
  • Dexmedetomidine administration may lead to delayed emergence from anesthesia.
  • The findings support dexmedetomidine as a potential agent for managing EA, balanced against potential delays in recovery.
Abstract

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