Effect of dezocine combined with dexmedetomidine used in pediatric anesthesia

Abstract

Objective To investigate the effect of dezocine alone or combined with dexmedetomidine (Dex) in pediatric anesthesia.Methods Sixty ASA Ⅰ-Ⅱ pediatric patients,aged 4 y-10 y,weighing 14 kg-40 kg,scheduled for tonsillectomy and adenoidectomy were randomly divided into three groups (n=20):the control group (group C),multimodal analgesia group (group M) and the dezocine group (group D).Patients in M group started with intravenous infusion of Dex(1 μg/kg) for 10 min.After 10 min,Dex (0.5 μg·kg-1·h-1) were continually given to patients for 1 h.Patients in group C and group D received the same volume of normal saline.Group M and group D received dezocine (0.1 mg/kg) 15 min before the end of surgery,group C received the same volume of normal saline.Three groups use the same induction and maintenance of anesthesia.Vital signs were compared among the three groups at 5 time points:patient entering the operation room (T1),5 min after intravenous infusion (T2),intubation(T3),extubation(T4),5 min after extubation(T5).The duration of anesthesia and surgery,duration for anesthesia recovery and extubation,postoperative agitation and adverse reaction were recorded as well.Results Compared with group C[65％,(3.2±1.0)],the incidence and the grading of agitation were lower in group M[10％,(2.0±0.7)] and group D [30％,(2.4±0.8)] in anesthesia recovery period (P＜ 0.05).Compared with group C [(8.8±2.5) ml],the intraoperative sevoflurane requirement was significantly lower in the group M [(5.8±2.0) ml] during the maintenance of anesthesia (P＜0.05).Compared with group C and group D,the heart rate was significantly lower in group M at T2-T5 (P＜0.05).Compared with group C,the incidence of postoperative tachycardia were lower in group M (35％ vs 0％)(P＜0.05).The duration of anesthesia,duration of operation,anesthesia recovery period and extubation were not statistically different between three groups (P＞0.05).Conclusions Injection of dezocine (0.1 mg/kg) at 15 min before the end of operation is safe for the pediatric patients and can effectively reduce postoperative agitation.This usage of dezocine combined with Dex grants advantages in pediatric multimodal analgesia.It has an analgesic-sparing effect,and maintains the patients' vital sign stable throughout the perioperative period.This approach improves the recovery quality and therefore the patients'/family's satisfaction. Key words: Dezocine; Dexmedetomidine; Perianesthesia; Pediatric