Abstract
BackgroundTo determine whether continuous intravenous infusion of dexmedetomidine (DEX) can affect the incidence of Emergence Agitation (EA) after general anesthesia in infant undergoing cleft palate repair surgery.MethodsForty infants underwent cleft palate repair surgery under general anesthesia were randomly divided into the DEX (D) group and Placebo (P) groups. Patients in group D received continuous intravenous infusion of DEX 0.8 μg · kg-1 · min-1 after the induction. Patients in group P were administered with continuous intravenous infusion of the equivalent volume of normal saline. Both groups were induced with fentanyl 0.005 mg/Kg, propofol 2 mg/Kg and cisatracurium 0.2 mg/Kg. Anaesthesia was maintained with continuous intravenous infusion of propofol (2 mg/Kg · h), remifentanil (0.1 μg/Kg · h), and inhalation of 1 to 3 % sevoflurane.ResultThe heart rate (HR) in group P was significant higher than that in group D at the time of operation (P < 0.05), postoperative 15 min, 30 min and the time of extubation (P < 0.01). The mean arterial pressure (MAP) in group P was higher comparing with MAP in group D at the time of extubation (P < 0.05). The spontaneous eye opening times and spontaneous arm or leg motion times were longer in group D (P < 0.05). The mean agitation scores of patients in group D were significantly lower than that in group P (P < 0.01). However, the incidence of EA in group P and group D was 90 % and 15 % (P <0.05).ConclusionThe continuous intravenous infusion of DEX after induction could significantly reduce the occurrence of EA.Trial registrationThe Chinese Clinical Trial Register ChiCTR-TRC-13003865
Highlights
To determine whether continuous intravenous infusion of dexmedetomidine (DEX) can affect the incidence of Emergence Agitation (EA) after general anesthesia in infant undergoing cleft palate repair surgery
There were no significant differences in gender, age, body weight, American Society of Anesthesiologists (ASA), during of operation and during of anesthesia between two groups (Table 2)
Comparing with group D, the heart rate (HR) was higher in group P during the time of operation (P = 0.014), postoperative 15 min (P = 0.003), postoperative 30 min (P = 0.0004)
Summary
To determine whether continuous intravenous infusion of dexmedetomidine (DEX) can affect the incidence of Emergence Agitation (EA) after general anesthesia in infant undergoing cleft palate repair surgery. Cleft palate repair is one of the most common oral and maxillofacial sugery in children and it may be associated with significant postoperative pain. Anesthetic management during the cleft palate surgical repair always has a high rate (13 %) of postoperative complications including postoperative swelling of the tongue, bleeding which maybe because the surgical procedure and the complications included pain, nausea and. The typical anesthesia method of infant is inhalational anesthetic. Sevoflurane, as a popular inhalational anesthetic for children, has been routinely used because it is less pungent and has a more rapid onset and offset because of lower solubility in blood, fast recovery properity, relative lack of airway irritation and greater hemodynamic stability. EA has a phenomenon of nonpurposeful restlessness and agitation, thrashing, crying or moaning, disorientation, and incoherence [9], which frequently happened when children recovering from anesthesia and can create a challenging situation to their health care providers
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