Abdel-Rahman Khaled Abdel-Baky, Abd-Elshafy Sayed Kaoud, Sayed Jehan A
Assiut University, College of Medicine, Assiut, Egito.
Assiut University, College of Medicine, Assiut, Egito.
Braz J Anesthesiol. 2018 Nov-Dec;68(6):571-576. doi: 10.1016/j.bjan.2018.05.002. Epub 2018 Sep 7.
Emergence agitation is a postoperative negative behavior that affects mainly children. We studied the effect of two different doses of dexmedetomidine on the incidence and degree of EA in children undergoing strabismus surgery.
90 patients were allocated into three equal groups; patients received 0.5 μg.kg of dexmedetomidine in high Dex group, 0.25 μg.kg of dexmedetomidine in low Dex group, or normal saline in the placebo group. All drugs were received with the closure of the conjunctiva before the end of the surgery. Pediatric Anesthesia Emergence Delirium (PAED) scale was used to evaluate the agitation, and Face, Legs, Activity, Cry, Consolability (FLACC) scale was used for pain assessment. Adverse effects of dexmedetomidine and recovery times were recorded.
The incidence of agitation was significantly lower in high Dex group compared to other groups and it was significantly lower in low Dex group compared to placebo group. The median (range) of FLACC score was significantly lower in both Dex groups compared to placebo group. Recovery times; time from removal of laryngeal mask to eye opening and time stay in post anesthesia care unit was significantly longer in high Dex group compared to other groups. No significant bradycardia or hypotension was recorded. Recovery time was significantly longer in high Dex group compared to the other two groups.
Dexmedetomidine (0.5 μg.kg) before emergence from general anesthesia resulted in a reduction in the incidence of emergence agitation compared to a dexmedetomidine (0.25 μg.kg) but on the expense of recovery times without adverse effects.
苏醒期躁动是一种主要影响儿童的术后不良行为。我们研究了两种不同剂量的右美托咪定对斜视手术患儿苏醒期躁动的发生率和程度的影响。
90例患者被平均分为三组；高剂量右美托咪定组患者接受0.5μg/kg的右美托咪定，低剂量右美托咪定组患者接受0.25μg/kg的右美托咪定，安慰剂组患者接受生理盐水。所有药物均在手术结束前结膜闭合时给予。采用小儿麻醉苏醒期谵妄（PAED）量表评估躁动情况，采用面部、腿部、活动、哭闹、安慰（FLACC）量表评估疼痛情况。记录右美托咪定的不良反应和恢复时间。
与其他组相比，高剂量右美托咪定组的躁动发生率显著降低，与安慰剂组相比，低剂量右美托咪定组的躁动发生率也显著降低。与安慰剂组相比，两个右美托咪定组的FLACC评分中位数（范围）均显著降低。恢复时间；与其他组相比，高剂量右美托咪定组从拔除喉罩到睁眼的时间以及在麻醉后护理单元的停留时间显著延长。未记录到明显的心动过缓或低血压。与其他两组相比，高剂量右美托咪定组的恢复时间显著延长。
与0.25μg/kg的右美托咪定相比，全身麻醉苏醒前给予0.5μg/kg的右美托咪定可降低苏醒期躁动的发生率，但以延长恢复时间为代价，且无不良反应。
