Appropriate dose of dexmedetomidine for the prevention of emergence agitation after general anesthesia for tonsillectomy in preschool children

Abstract

Objective To evaluate the effective dose of dexmedetomidine (DEX) for prevention of emergence agitation (EA) after total intravenous anesthesia or sevoflurane anesthesia for preschool children undergoing a tonsillectomy. Methods 80 preschool children undergoing a selective tonsillectomy were randomly divided into 2 groups: intravenous group (total intravenous anesthesia, n=40) and inhalation group (sevoflurane inhaled anesthesias, n=40). According to the spot-slope method, intravenous group and inhalation group were randomly divided into 5 dose groups and given DEX in a geometric progression after induction. The EA, adverse effects, the pain score and the postoperative behavioral outcomes of each child in the two groups were recorded. Results The ED50s for prevention of EA were 0.28 μg/(kg·h) in intravenous group and 0.34 μg/(kg·h) in inhalation group. The duration of children′s staying post-anesthesia care unit (PACU) and the incidence of pain were significantly greater in those with EA than those without (P 0.05). No severe adverse reactions were observed in 95% confidence limits. Conclusions 0.28 (0.22-0.35) μg/(kg·h) and 0.34 (0.27-0.43) μg/(kg·h) of DEX are safe and reliable for prevention of EA after intravenous anesthesia and sevoflurane anesthesia for preschool children undergoing a tonsillectomy. Key words: Dexmedetomidine/AD; Tonsillectomy; Anesthesia recovery period; Mood disorders/PC; Child, preschool