Impact of dexmedetomidine on agitation and inflammatory response during recovery from anesthesia in young children following cochlear implantation surgery

Abstract

Abstract Objective To evaluate the impact of dexmedetomidine (Dex) on agitation and inflammatory response during recovery from anesthesia in young children following cochlear implantation surgery. Methods We randomly divided 80 children who underwent unilateral cochlear implantation into two equal groups. Group D received an intravenous infusion of Dex after induction of anesthesia, while those in group C received an equal volume of saline infusion. The mean arterial pressure (MAP) and heart rate (HR) of children in the two groups were recorded at four different time intervals: before induction of anesthesia (T0); 30 min after intravenous infusion of Dex (T1); upon admission to the post-anesthesia care unit (PACU) (T2); and at the time of being transferred out of the PACU (T3). At T3, we also recorded general information. Results The MAP and HR in group D showed more consistent trends during the anesthesia recovery period when compared to those in group C. Children in group D had a significantly lower crying, requires increased O2 administration, increased vital signs, expression and sleepless score (CRIES score), pediatric anesthesia emergence delirium (PAED) score, and incidence of agitation than in group C (P < 0.01). The rate of supplementary pain relief for the children was lower in group D than in group C (P < 0.01). At T3, serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were lower in children in group D than in group C (P < 0.01). Compared to T0, the levels of serum IL-6 and TNF-α were higher in both groups at T3 (P < 0.01). Conclusion We found that the use of Dex helped reduce the occurrence and severity of agitation during anesthesia recovery in children after cochlear implantation surgery and improved postoperative inflammatory reactions. Clinical registration number Registration website: https://www.chictr.org.cn/searchproj.html . Registration number ChiCTR2400080937.

Keywords

• Anesthesia recovery
• Children
• Cochlear implantation
• Dexmedetomidine
• Inflammation
• Psychomotor agitation