Premedication with dexmedetomidine decreases emergence agitation after sevoflurane anesthesia in children

Abstract

Background Diagnostic procedures such as bone marrow aspiration and biopsy have increased in recent years. The pain during such procedures is too much for most children to tolerate, and therefore general anesthesia with sevoflurane is the only choice. Emergence agitation (EA) is described as a mental disturbance during the recovery from general anesthesia. The aim of this study is to test the hypothesis that, because of its sedative effects, the use of dexmedetomidine decreases EA and improves parents and nurses' satisfaction after sevoflurane-based anesthesia in children. Patients and methods A total of 200 children aged 2-6 years, scheduled for bone marrow aspirations and biopsies, in a hospital procedure room, were enrolled. Patients were randomized into two groups: group D, receiving dexmedetomidine (2 μg/kg) in 10 ml saline over 2 min; and group S, receiving 10 ml saline over 2 min. Procedure duration, recovery time, and discharge time were recorded. Agitation score and parents and nurses' satisfaction scores were assessed. Results There were no significant differences between groups in the duration of the procedure or the time of discharge. The recovery time was longer in group D. Both parents and nurses' satisfaction scores were significantly lower in group D. Both agitation score and percent of patients who had agitation were significantly lower in group D. The mean arterial blood pressure and heart rate were significantly lower in group D. Conclusion Dexmedetomidine is an effective drug to reduce EA in pediatric patients after sevoflurane anesthesia without prolongation in the time of discharge, and provide better parents and nurses' satisfaction scores, which may allow better performance of the nurses.