Assessment of the success of drugs to reduce the emergence agitation in children following Adenotonsillectomy

Abstract

Objective: To investigate the effects of remifentanil infusion and single dose dexmedetomidine on postoperative agitation after sevoflurane induction in pediatric patients who underwent adenotonsillectomy Design: A controlled, double blind study Setting: Operating room and postoperative recovery area Subjects: The study was controlled, double blind with 60 pediatric patients, aged 2 - 14 years who underwent the procedures of tonsillectomy/adenoidectomy and were randomized into remifentanil (group R, n = 20, 0.1 mu g/kg/min infusion) or dexmedetomidine (group D, n = 20, 0.3 mu g/kg single dose) or control (n = 20, 50% 0 2, 50% N(2)0, 1-2% sevoflurane) groups. Interventions: All of the patients underwent adenotonsillectomy and were randomized into remifentanil (n = 20), dexmedetomidine (n = 20) or control (n = 20) groups. Main outcome measures: Postoperative emerging agitation was evaluated by Modified Aldrete Scoring (MAS) System, Riker sedation-agitation score (RS) and Aono's four-point scale. Data were analyzed by descriptive statistics, paired one-way variance analysis, Newman Keuls and Tukey multiple comparison and Chi square tests. Results: Mean extubation time, the time of MAS reaching 9-10, mean heart rate, and mean arterial blood pressure were higher in group R (p > 0.05). Mean RS score of group D was statistically significantly lower than the other groups (p = 0.041). There were no statistically significant differences in mean values of ETCO2 and SpO(2) between the groups. Conclusions: We conclude that a dose of dexmedetomidine 0.3 mu g/kg administered after induction of anesthesia reduces the post sevoflurane agitation in children with no adverse effects.