Department of Anesthesiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
BMC Ophthalmol. 2020 Mar 5;20(1):86. doi: 10.1186/s12886-020-01359-3.
Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery.
In this prospective randomized double-blinded study, 126 pediatric patients undergoing strabismus surgery were randomized into one of three groups: Placebo group, normal saline; DEX1 group, 0.3 μg/kg dexmedetomidine, and DEX2 group, 0.5 μg/kg dexmedetomidine. Oculocardiac reflex (OCR) events were recorded during surgery. PONV or postoperative vomiting (POV) was recorded for 24 h in the ward. Pediatric anesthesia emergence delirium (PAED) scale and emergence agitation (EA) scale were recorded in the recovery room.
Intraoperative OCR was significantly reduced in DEX2 group (42%) as compared to that of Placebo group (68%) (p = 0.0146). During the first 24 h post-op, the overall incidence of PONV was significantly lower in DEX2 group (10%) than that of Placebo group (32%) (p = 0.0142). There was no significant difference in POV among the three groups. PAED or EA scores among the three groups were similar during recovery time.
Dexmedetomidine (0.5 μg/kg) reduced OCR and PONV without lengthening extubation time or recovery time in pediatric patients undergoing strabismus surgery.
The trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR1800020176, Date: 12/19/2018).
斜视手术后恶心和呕吐(PONV)是常见的副作用。本研究旨在比较不同剂量右美托咪定(DEX)对斜视手术患儿 PONV 发生率的影响。
在这项前瞻性随机双盲研究中,126 名接受斜视手术的儿科患者被随机分为三组:安慰剂组,生理盐水;DEX1 组,0.3μg/kg 右美托咪定;DEX2 组,0.5μg/kg 右美托咪定。术中记录眼心反射(OCR)事件。术后在病房内记录 24 小时内 PONV 或术后呕吐(POV)。在恢复室记录小儿麻醉苏醒期谵妄(PAED)评分和苏醒期躁动(EA)评分。
DEX2 组术中 OCR 明显低于安慰剂组(42% vs. 68%,p=0.0146)。术后 24 小时内,DEX2 组总体 PONV 发生率(10%)明显低于安慰剂组(32%)(p=0.0142)。三组间 POV 发生率无差异。三组恢复期间的 PAED 或 EA 评分相似。
右美托咪定(0.5μg/kg)可减少 OCR 和 PONV,而不延长斜视手术患儿的拔管时间或恢复时间。
在患者入组前,该试验前瞻性地在中国临床试验注册中心(临床试验编号:ChiCTR1800020176,日期:2018 年 12 月 19 日)注册。