Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

Abstract

Background: Emergence delirium (ED) is a frequent postoperative complication in young children undergoing cleft palate repair and it may be exacerbated by sevoflurane anesthesia. Objective: This study was undertaken to study the effect of magnesium sulphate or dexamethasone as adjuvants to sevoflurane in decreasing the delirium after primary cleft palate repair. Patients and methods: 90 patients undergoing primary cleft palate repair were randomized into 3 groups equally. Controlled group (group C): continue without any addition, Magnesium group (group M): 30 mg/kg loading dose on 10 min then 10 mg/kg every one hour though the operation and Dexamethasone group (group D): 0.15 mg/kg single dose after induction. During the study period, heart rate, mean arterial blood pressure, postoperative delirium, blood glucose level and nausea were recorded for 120 min. Results: The heart rate and blood pressure were significantly decreased in group M and group D, than the control group. Significant lower postoperative delirium and nausea in group D and M in comparison with control group although D group had the best effects. Conclusion: Co-administration of intravenous magnesium sulphate or dexamethasone with to sevoflurane anesthesia during primary cleft palate repair provides more vital hemodynamic state and decrease in postoperative vomiting and delirium when compared with control group.

Keywords

• Cleft palate
• Sevoflurane
• Magnesium sulphate
• Dexamethasone
• Delirium