Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial
Objectives: In infants, there is a high incidence of emergence agitation (EA) after sevoflurane (Sev) anesthesia. This study aimed to test the hypothesis that dexmedetomidine (Dex) administration would reduce the incidence and severity of EA after Sev-based anesthesia in infants undergoing palatopla...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-01-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001415000214 |
| _version_ | 1811203069829971968 |
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| author | Aiji Boku Hiroshi Hanamoto Aiko Oyamaguchi Mika Inoue Yoshinari Morimoto Hitoshi Niwa |
| author_facet | Aiji Boku Hiroshi Hanamoto Aiko Oyamaguchi Mika Inoue Yoshinari Morimoto Hitoshi Niwa |
| author_sort | Aiji Boku |
| collection | DOAJ |
| description | Objectives: In infants, there is a high incidence of emergence agitation (EA) after sevoflurane (Sev) anesthesia. This study aimed to test the hypothesis that dexmedetomidine (Dex) administration would reduce the incidence and severity of EA after Sev-based anesthesia in infants undergoing palatoplasty. Methods: A prospective randomized clinical trial was conducted with 70 patients undergoing palatoplasty, aged 10–14 months. Infants were randomly allocated into two groups: Dex (n = 35) and saline (n = 35). In the Dex group, Dex (6 μg/kg/h) was administered approximately 10 min before the end of the surgery for 10 min, followed by 0.4 μg/kg/h until 5 min after extubation. In the saline group, an equivalent amount of saline was administered in a similar manner. After the surgery, patients were transferred to the postanesthetic care unit (PACU). The infant's behavior and pain were assessed with scoring system for EA (5-point rating scale) and pain scale (PS; 10-point rating scale), respectively. EA and PS were estimated at six time points (after extubation, leaving the operating room, 0, 30, 60, and 120 min after arrival in PACU). Results: EA and PS scores were significantly lower in the Dex group than in the saline group from extubation to 120 min after arrival in PACU. Conclusions: Dex administration has the advantage of a reduced EA and PS without any adverse effects. Dex provided satisfactory recovery in infants undergoing palatoplasty. Resumo: Objetivos: Em crianças, é elevada a incidência de surgimento de agitação (SA) em seguida à anestesia com sevoflurano (Sev). Este estudo teve como objetivo testar a hipótese de que a administração de dexmedetomidina (Dex) reduziria a incidência e gravidade do SA após anestesia com Sev em lactentes submetidos à palatoplastia. Métodos: Estudo clínico prospectivo randomizado, realizado com 70 pacientes submetidos a uma palatoplastia, com idades entre 10-14 meses. As crianças foram divididas randomicamente em dois grupos: Dex (n = 35) e solução salina (n = 35). No grupo de Dex, Dex (6 μg/kg/h) foi administrada cerca de 10 minutos antes do final da cirurgia durante 10 min, seguida de 0,4 μg/kg/h até 5 minutos após a extubação. No grupo de solução salina, uma quantidade equivalente de salina foi administrada com o mesmo esquema de dosagem. Após a cirurgia, os pacientes foram transferidos para a unidade de cuidados pós-anestésicos (UCPA). O comportamento e a dor dos bebês foram avaliados com um sistema de pontuação para SA (escala de classificação de 5 pontos) e com uma escala de dor (ED; escala de classificação de 10 pontos), respectivamente. SA e ED foram estimados em seis pontos cronológicos (após a extubação, ao deixar a sala de cirurgia, e 0, 30, 60 e 120 minutos após a chegada à UCPA). Resultados: Os escores SA e ED foram significativamente menores no grupo Dex versus grupo salina, desde a extubação até 120 min após a chegada à UCPA. Conclusões: A administração de Dex tem a vantagem de uma redução no SA e na ED, sem quaisquer efeitos adversos. Dex proporcionou uma recuperação satisfatória em lactentes submetidos à palatoplastia. Keywords: Dexmedetomidine, Sevoflurane, Palatoplasty, Agitation, Infant, Post operative pain, Palavras-chave: Dexmedetomidina, Sevoflurano, Palatoplastia, Agitação, Bebê, Dor pós-operatória |
| first_indexed | 2024-04-12T02:48:22Z |
| format | Article |
| id | doaj.art-2995f6cb6f674746a2144d3ea8ac4fe6 |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T02:48:22Z |
| publishDate | 2016-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-2995f6cb6f674746a2144d3ea8ac4fe62022-12-22T03:51:04ZengElsevierBrazilian Journal of Anesthesiology0104-00142016-01-016613743Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trialAiji Boku0Hiroshi Hanamoto1Aiko Oyamaguchi2Mika Inoue3Yoshinari Morimoto4Hitoshi Niwa5Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, Osaka, Japan; Corresponding author.Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, Osaka, JapanDepartment of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, Osaka, JapanDepartment of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, Osaka, JapanSpecial Patient Oral Care Unit, Kyushu University Hospital, Fukuoka, JapanDepartment of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, Osaka, JapanObjectives: In infants, there is a high incidence of emergence agitation (EA) after sevoflurane (Sev) anesthesia. This study aimed to test the hypothesis that dexmedetomidine (Dex) administration would reduce the incidence and severity of EA after Sev-based anesthesia in infants undergoing palatoplasty. Methods: A prospective randomized clinical trial was conducted with 70 patients undergoing palatoplasty, aged 10–14 months. Infants were randomly allocated into two groups: Dex (n = 35) and saline (n = 35). In the Dex group, Dex (6 μg/kg/h) was administered approximately 10 min before the end of the surgery for 10 min, followed by 0.4 μg/kg/h until 5 min after extubation. In the saline group, an equivalent amount of saline was administered in a similar manner. After the surgery, patients were transferred to the postanesthetic care unit (PACU). The infant's behavior and pain were assessed with scoring system for EA (5-point rating scale) and pain scale (PS; 10-point rating scale), respectively. EA and PS were estimated at six time points (after extubation, leaving the operating room, 0, 30, 60, and 120 min after arrival in PACU). Results: EA and PS scores were significantly lower in the Dex group than in the saline group from extubation to 120 min after arrival in PACU. Conclusions: Dex administration has the advantage of a reduced EA and PS without any adverse effects. Dex provided satisfactory recovery in infants undergoing palatoplasty. Resumo: Objetivos: Em crianças, é elevada a incidência de surgimento de agitação (SA) em seguida à anestesia com sevoflurano (Sev). Este estudo teve como objetivo testar a hipótese de que a administração de dexmedetomidina (Dex) reduziria a incidência e gravidade do SA após anestesia com Sev em lactentes submetidos à palatoplastia. Métodos: Estudo clínico prospectivo randomizado, realizado com 70 pacientes submetidos a uma palatoplastia, com idades entre 10-14 meses. As crianças foram divididas randomicamente em dois grupos: Dex (n = 35) e solução salina (n = 35). No grupo de Dex, Dex (6 μg/kg/h) foi administrada cerca de 10 minutos antes do final da cirurgia durante 10 min, seguida de 0,4 μg/kg/h até 5 minutos após a extubação. No grupo de solução salina, uma quantidade equivalente de salina foi administrada com o mesmo esquema de dosagem. Após a cirurgia, os pacientes foram transferidos para a unidade de cuidados pós-anestésicos (UCPA). O comportamento e a dor dos bebês foram avaliados com um sistema de pontuação para SA (escala de classificação de 5 pontos) e com uma escala de dor (ED; escala de classificação de 10 pontos), respectivamente. SA e ED foram estimados em seis pontos cronológicos (após a extubação, ao deixar a sala de cirurgia, e 0, 30, 60 e 120 minutos após a chegada à UCPA). Resultados: Os escores SA e ED foram significativamente menores no grupo Dex versus grupo salina, desde a extubação até 120 min após a chegada à UCPA. Conclusões: A administração de Dex tem a vantagem de uma redução no SA e na ED, sem quaisquer efeitos adversos. Dex proporcionou uma recuperação satisfatória em lactentes submetidos à palatoplastia. Keywords: Dexmedetomidine, Sevoflurane, Palatoplasty, Agitation, Infant, Post operative pain, Palavras-chave: Dexmedetomidina, Sevoflurano, Palatoplastia, Agitação, Bebê, Dor pós-operatóriahttp://www.sciencedirect.com/science/article/pii/S0104001415000214 |
| spellingShingle | Aiji Boku Hiroshi Hanamoto Aiko Oyamaguchi Mika Inoue Yoshinari Morimoto Hitoshi Niwa Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial Brazilian Journal of Anesthesiology |
| title | Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial |
| title_full | Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial |
| title_fullStr | Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial |
| title_full_unstemmed | Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial |
| title_short | Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial |
| title_sort | effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty a randomized controlled trial |
| url | http://www.sciencedirect.com/science/article/pii/S0104001415000214 |
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