Comparison of the effects of dexmedetomidine, ketamine, and placebo on emergence agitation after strabismus surgery in children

Jan 25, 2013Canadian journal of anaesthesia = Journal canadien d'anesthesie

Comparing dexmedetomidine, ketamine, and placebo for calming children after eye muscle surgery

AI simplified

Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

In a study of 78 children undergoing strabismus surgery, dexmedetomidine was associated with a 15% incidence of postoperative vomiting compared to 44% in the ketamine group and 45.8% in the placebo group.

Peak agitation scores were significantly lower in both the dexmedetomidine and ketamine groups compared to the placebo group.
Dexmedetomidine and ketamine were linked to reduced pain scores on the ward compared to placebo.
The time to resumption of mental orientation and discharge from the postanesthetic care unit was longer for those receiving dexmedetomidine and ketamine compared to the placebo group.
The incidence of postoperative vomiting was notably reduced with dexmedetomidine compared to ketamine and placebo.

AI simplified

BACKGROUND: Children undergoing strabismus surgery under sevoflurane anesthesia often experience emergence agitation (EA) and postoperative vomiting (POV). This study compared the effects of intraoperative dexmedetomidine, ketamine, and placebo on postoperative EA and POV.

METHODS: Eighty-four children (aged two to seven years) undergoing elective strabismus surgery under sevoflurane anesthesia were randomly assigned to one of three groups (n = 28 each). Intraoperatively, the placebo, dexmedetomidine, and ketamine groups received normal saline, dexmedetomidine 1 μg·kg(-1) iv plus a 1 μg·kg(-1)·hr(-1) infusion, and ketamine 1 mg·kg(-1) iv plus a 1 mg·kg(-1)·hr(-1) infusion, respectively. Agitation scores (Pediatric Anesthesia Emergence Delirium [PAED] scale) and POV were assessed in the postanesthetic care unit (PACU) and for 24 hr on the ward. Pain scores and times to laryngeal mask airway (LMA™) removal, resumption of mental orientation, and discharge from the PACU were also assessed.

RESULTS: Seventy-eight children completed the study. Peak PAED scores for EA were lower in the dexmedetomidine (P < 0.001) and ketamine (P = 0.002) groups than in the placebo group. Incidence of POV was lower in the dexmedetomidine group (15%) than in the ketamine (44%; P = 0.02) or placebo (45.8%; P = 0.02) groups. Pain scores on the ward were lower in the dexmedetomidine (P < 0.001) and ketamine (P < 0.001) groups than in the placebo group. Time to LMA removal was similar in all groups. Time for resumption of mental orientation and time to discharge from PACU were longer in the dexmedetomidine and ketamine groups than in the placebo group.

CONCLUSIONS: Dexmedetomidine and ketamine appear to prevent postoperative agitation and pain after sevoflurane anesthesia for pediatric strabismus surgery. Dexmedetomidine also prevents POV.

Full Text

Full text is available at the source.

View full text (PDF) ↗View full text (HTML) ↗View full text ↗

Comparison of the effects of dexmedetomidine, ketamine, and placebo on emergence agitation after strabismus surgery in children

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief