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Category: Volume 07 Issue 05 May 2019
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Title: Effect of Dexmendetomidine on Emergence Agitation in Children Undergoing Surgeries using Sevoflurane- Randomized Controlled Observational Study

Authors: Dr Mukesh Kumar, Dr Mukesh Kumar Kanth, Dr Usha Suwalka

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.157

Abstract

Background: Emergence agitation is one of the post-operative complication after paediatric surgeries. Its incidence ranging in literature from 10% to 80%1. Sevoflurane is very commonly used inhalational anaesthetic agent in induction and maintenance of anaesthesia. Incidence of emergence agitation may be high as 67%2 when Sevoflurane is used.

Study Design: Randomized controlled observational study

Objective: Aim of this study was to assess the effect of DEXMENDETOMIDINE in prevention of emergence agitation in children (between 6 and 12 yrs of age) after undergoing various surgeries using Sevoflurane as an anaesthetic agent.

Method: This study included 150 patients randomly classified into two groups. Group A underwent surgeries using sevoflurane as sole anaesthetic agent and Group B underwent surgeries using Sevoflurane with Dexmendetomidine intravenously. In Post operative stage all patients were assessed for emergence agitation using PAED3 scale. Those having PAED score equal to or more than 16 were considered agitated.

Result: Dexmendetomidine group had reduced emergence agitation (10.7%).

Keywords: Emergence agitation, objective pain scale, Sevoflurane, Dexmendetomidine.

References

  1. Voepel - Lewis, S. Malviya, A.R. Tait: A prospective cohort study of emergence agitation in pediatric post anaesthesia Care Unit Anaesth Anlog, 96(2003), PP, 1625-1630
  2. Davis PJ, Greenberg JA, Gendelman M, Fertal K. Recovery characteristics of sevoflurane and halothane in preschool-aged children undergoing bilateral myringotomy and pressure equalization tube insertion. Anesth Anlog 1999; 88:34-8.
  3. Phan, M.C. Nahata: Clinical uses of dexmedetomidine in pediatric patients, 10 (2008), PP.49-69.
  4. Vitanen H, Annila P, Viitanen M, Takkila P. Premedication with midazolam delays recovery after ambulatory sevoflurane anaesthesia in children, Anesth Anlog 1999; 89;75-9.
  5. Manna EM, Abdelhaleem AA, Mohamed EA.Fentanyl versus dexmedetomidine effect on agitation after sevoflurane anaesthesia. Saudi Journal of Anaesthesia 2007; 1(2):57-61.
  6. Sv, G.B. HammerDexmedetomidine: Pediatric pharmacology, Clinical uses & Safety Expert opin Drug Saf (2011), PP 55-66.
  7. Welborn LG, Hannallah RS, Norden JM, et al. Comparison of emergence and recovery characteristics of sevoflurane, desflurane, and halothane in pediatric ambulatory patients. AnesthAnalg 1996;83:917-20.
  8. Ibacache ME, Munoz HR, Brandes V, et al. Single-dose dexmedetomidine reduces agitation after sevoflurane anaesthesia in children. Anesth Analg 2004;98:60-3.

Corresponding Author

Dr Usha Suwalka
Prof. & HOD, Department of Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, India