Single-Dose Dexmedetomidine Reduces Agitation After Sevoflurane Anesthesia in Children

• Published in: Anesthesia and analgesia Vol. 98; no. 1; pp. 60 - 63
• Main Authors: Ibacache, Mauricio E., Muñoz, Hernán R., Brandes, Verena, Morales, Anita L.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01-01-2004; Lippincott
• Subjects: Aging; Anesthesia; Anesthesia Recovery Period; Anesthesia, Inhalation - adverse effects; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Inhalation - adverse effects; Biological and medical sciences; Blood Pressure - drug effects; Child; Child, Preschool; Dexmedetomidine - therapeutic use; Female; Heart Rate - drug effects; Hernia, Inguinal - surgery; Humans; Hypnotics and Sedatives - therapeutic use; Infant; Male; Medical sciences; Methyl Ethers - adverse effects; Prospective Studies; Psychomotor Agitation - prevention & control; Sevoflurane; Sex Characteristics; Human; Sevoflurane; Agitation; General anesthetic; Dexmedetomidine; Single dose; Anesthesia; Child
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1213/01.ANE.0000094947.20838.8E

Emergence agitation is a common side effect of sevoflurane anesthesia in children. Dexmedetomidine, because of its sedative and analgesic properties, might be useful for the management of this adverse effect. We studied the effect of dexmedetomidine on recovery characteristics in 90 children aged 1 to 10 yr scheduled to undergo superficial lower abdominal and genital surgery. After inhaled induction with sevoflurane, patients were randomly assigned to receive saline (Group 1, n = 30), dexmedetomidine 0.15 μg/kg (Group 2, n = 30), or dexmedetomidine 0.30 μg/kg (Group 3, n = 30). After a laryngeal mask airway insertion a caudal block was performed in all patients. Maintenance of anesthesia was with 1% end-tidal sevoflurane and 50% nitrous oxide and spontaneous ventilation. Intraoperative hemodynamic and respiratory variables were recorded every 5 min. At the end of anesthesia time to eyes opening (TEO) and characteristics of emergence were recorded. General and intraoperative variables were similar in the 3 groups. The TEO was 7.5 ± 5.0 min in Group 1, 8.2 ± 5.0 min in Group 2, and 9.8 ± 4.0 min in Group 3 (NS). The incidence (95% confidence interval) of agitation was 37% (20%–54%) in Group 1, 17% (4%–30%) in Group 2, and 10% (0%–21%) in Group 3 (P < 0.05). Paired comparisons showed a significant difference for Group 1 versus Group 3 (P < 0.05, 95% confidence interval of the difference7%–47%). The time to discharge from the postanesthesia care unit was similar for the 3 groups. We conclude that a dose of dexmedetomidine 0.3 μg/kg administered after induction of anesthesia reduces the postsevoflurane agitation in children and with no adverse effects.