Ramachandran Abinaya, Palanisamy Nagalakshmi, Vidya M V, Zachariah Mamie, George Sagiev K, Ranjan R V
Department of Anaesthesiology and Critical Care, Pondicherry Institute of Medical Sciences, Pondicherry, India.
Indian J Anaesth. 2021 Jul;65(7):519-524. doi: 10.4103/ija.IJA_168_21. Epub 2021 Jul 23.
Emergence agitation (EA) in children is one of the most common postoperative problems encountered in the recovery room. Sevoflurane has been strongly associated with EA owing to its lower solubility and rapid recovery. Dexmedetomidine has been found to reduce the incidence of EA. This study was designed to evaluate the effectiveness of dexmedetomidine in two doses in reducing EA in children.
This was a prospective double-blinded randomised study done on eighty children aged 5-14 years undergoing adenotonsillectomy/tonsillectomy under sevoflurane anaesthesia. Patients in Group A ( = 40) received 0.3 μg/kg/h and patients in group B ( = 40) received 0.5 μg/kg/h infusion after a bolus dose of 0.5 μg/kg of dexmedetomidine. The primary objective was to compare two different doses of dexmedetomidine on EA in the postoperative period. The secondary objectives were to assess the pain and perioperative haemodynamics in the recovery room. The anaesthesiologist blinded to the study charted the paediatric anaesthesia emergence delirium score (PAED), perioperative haemodynamic parameters, objective pain score and rescue medications if given. The data were analysed using Student's unpaired -test, Chi-square test, repeated measures Analysis of Variance (ANOVA) and Mann-Whitney U test wherever appropriate.
The incidence of EA was comparable between both groups ( = 0.960). The haemodynamic parameters ( > 0.05) and the objective pain score ( = 0.810) also did not show a statistically significant difference.
A lower dose of dexmedetomidine (0.3 μg/kg/h) is equally effective as a higher dose (0.5 μg/kg/h) after a bolus dose of 0.5 μg/kg in decreasing EA.
小儿苏醒期躁动（EA）是恢复室中最常见的术后问题之一。七氟醚因其较低的溶解度和快速苏醒，与EA密切相关。右美托咪定已被证实可降低EA的发生率。本研究旨在评估两种剂量的右美托咪定在降低小儿EA方面的有效性。
这是一项前瞻性双盲随机研究，对80例年龄在5至14岁、在七氟醚麻醉下接受腺样体扁桃体切除术/扁桃体切除术的儿童进行。A组（n = 40）患者在静脉推注0.5 μg/kg右美托咪定后，接受0.3 μg/（kg·h）的输注；B组（n = 40）患者接受0.5 μg/（kg·h）的输注。主要目的是比较两种不同剂量的右美托咪定在术后对EA的影响。次要目的是评估恢复室中的疼痛和围手术期血流动力学。对研究情况不知情的麻醉医生记录小儿麻醉苏醒期谵妄评分（PAED）、围手术期血流动力学参数、客观疼痛评分以及是否使用了急救药物。数据在适当情况下使用学生独立样本t检验、卡方检验、重复测量方差分析（ANOVA）和曼-惠特尼U检验进行分析。
两组的EA发生率相当（P = 0.960）。血流动力学参数（P > 0.05）和客观疼痛评分（P = 0.810）也未显示出统计学上的显著差异。
在静脉推注0.5 μg/kg后，较低剂量的右美托咪定（0.3 μg/（kg·h））在降低EA方面与较高剂量（0.5 μg/（kg·h））同样有效。
