Comparison of dexmedetomidine in two different doses on emergence agitation in children under sevoflurane anaesthesia: A double-blind randomised controlled trial

Abstract

Background and Aims: 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. Methods: 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 (n = 40) received 0.3 μg/kg/h and patients in group B (n = 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 t-test, Chi-square test, repeated measures Analysis of Variance (ANOVA) and Mann-Whitney U test wherever appropriate. Results: The incidence of EA was comparable between both groups (P = 0.960). The haemodynamic parameters (P > 0.05) and the objective pain score (P = 0.810) also did not show a statistically significant difference. Conclusion: 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.

Keywords

• adenotonsillectomy
• dexmedetomidine
• emergence agitation
• sevoflurane
• tonsillectomy