Effect of intranasal dexmedetomidine versus peribulbar block on prevention of sevoflurane related emergence agitation in children undergoing unilateral strabismus surgery: A randomized, controlled study

Abstract

Background Emergence agitation (EA) and postoperative pain and vomiting (POV) are often complicating the recovery of children after strabismus surgery under sevoflurane anesthesia. This study compared the effects of preoperative intranasal dexmedetomidine versus peribulbar local anesthetic (LA) block technique for strabismus surgery on EA and POV. Patients and methods Seventy-five children undergoing elective unilateral strabismus surgery under sevoflurane anesthesia were randomly assigned to one of three equal groups (n=25 each). The dexmedetomidine group (group D) received intranasal dexmedetomidine 1 μg/kg preoperatively. The LA group (group L) received peribulbar 2–5 ml of LA mixture (in the form of lidocaine : bupivacaine 1 : 1 ratio) in the operable eye after induction of anesthesia. The control group (group C) received (normal saline) intravenous infusion. In the postanesthesia care unit, pediatric anesthesia emergence delirium scale, Modified Childern’s Hospital of Eastern Ontario Pain Score pain score and POV were assessed. Recovery time and postanesthesia care unit stay were also assessed. Results Seventy-five patients completed the study, pediatric anesthesia emergence delirium scale score was significantly lower in both the local peribulbar group and the dexmedetomidine group than in the placebo group (P Conclusion Peribulbar LA and intranasal dexmedetomidine seem to decrease the incidence of postoperative pain and EA in children undergoing unilateral strabismus surgery under sevoflurane anesthesia.