Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: a randomized controlled study

Shuangshuang Li,Tingjie Liu,Junming Xia,Wenxian Li,Jie Jia

doi:10.1186/s12886-020-01359-3

Shuangshuang Li, Tingjie Liu + Show 3 more

Open Access

https://doi.org/10.1186/s12886-020-01359-3

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Journal: BMC Ophthalmology	Publication Date: Mar 5, 2020
Citations: 19	License type: open-access

Affiliation: Eye & ENT Hospital of Fudan University

Abstract

BackgroundPostoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery.MethodsIn this prospective randomized double-blinded study, 126 pediatric patients undergoing strabismus surgery were randomized into one of three groups: Placebo group, normal saline; DEX1 group, 0.3 μg/kg dexmedetomidine, and DEX2 group, 0.5 μg/kg dexmedetomidine. Oculocardiac reflex (OCR) events were recorded during surgery. PONV or postoperative vomiting (POV) was recorded for 24 h in the ward. Pediatric anesthesia emergence delirium (PAED) scale and emergence agitation (EA) scale were recorded in the recovery room.ResultsIntraoperative OCR was significantly reduced in DEX2 group (42%) as compared to that of Placebo group (68%) (p = 0.0146). During the first 24 h post-op, the overall incidence of PONV was significantly lower in DEX2 group (10%) than that of Placebo group (32%) (p = 0.0142). There was no significant difference in POV among the three groups. PAED or EA scores among the three groups were similar during recovery time.ConclusionDexmedetomidine (0.5 μg/kg) reduced OCR and PONV without lengthening extubation time or recovery time in pediatric patients undergoing strabismus surgery.Trial registrationThe trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR1800020176, Date: 12/19/2018).

Highlights

Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery
According to the results of Pearson Chi-Square test, the incidence of intraoperative oculocardiac reflex was significantly reduced in the DEX2 group (42%) as compared to the Placebo group (68%) (p = 0.0146)
There was no significant difference between the DEX2 group and the Placebo group based on the results of Yates correction (p = 0.026)

Summary

Introduction

Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery. Often considered a minor side effect, postoperative nausea and vomiting (PONV) are common unpleasant adverse effects after surgery and may increase patient discomfort, result in serious complications, and delay patient discharge. Despite numerous efforts to decrease the incidence of PONV, it remains a significant challenge in pediatric patients undergoing strabismus surgery. In the past few years, many studies in pediatrics have been published showing that dexmedetomidine lowered postoperative pain scores and opioid consumption, decreased the incidence of emergence agitation (EA) and improved the quality of recovery in pediatric patients undergoing different surgical procedures [10,11,12]. The effect of dexmedetomidine on PONV remains poorly understood

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