Influence of dexmedetomidine injected before induction of anesthesia on pediatric postoperative analgesia and sedate effects with remifentanil

Abstract

Objective To observe the influence and safety of dexmedetomidine 1 μg/kg given before the induction of anesthesia on the analgesic and sedate effects of remifentanil in pediatric postoperative analgesia. Methods Sixty children scheduled for bowel resection surgery were randomly divided into 2 groups: dexmedetomidine combined with remifentanil group (group DR, n=30) and remifentanil group (group R, n=30) . Dexmedetomidine 1 μg/kg was given before the induction of anesthesia in group DR, normal saline in group R. Analgesic mixture including remifentanil 24 μg/kg, granisetron 0.1 mg/kg, diluted to 100 ml, was given to both groups. The postoperative analgesia and sedation was assessed with FACES Face Ratings and Ramsay score at the end of operation, and at 2, 6, 12 and 48 h after surgery. Times of pressed the analgesic pump, the incidence of side effects and parent’s satisfaction scores were recorded. Results FACES and Ramsay scores in group DR were significantly better than those in group R (P<0.05) . There was no occurrence of respiratory depression in both groups. Parent’s postoperative satisfaction score in group DR was higher than that in group R (P<0.05) . There were 5 patients vomiting in group R, but only 1 in group DR (P<0.05) . Conclusion With application of dexmedetomidine 1 μg/kg given before the induction of anesthesia, the analgesic and sedation effects of remifentanil can be improved, with high comfort level and patient’s satisfaction, which is better than application of remifentanil only. Key words: Dexmedetomidine; Remifentanil; Child; Analgesic; Composure