Effective dose of dexmedetomidine for the prevention of emergence agitation after desflurane anesthesia for cleft lip repair surgery in children

doi:10.3877/cma.j.issn.1674-1366.2016.05.008

Abstract

Abstract:

Objective

To evaluate the effective dose of dexmedetomidine for the prevention of emergence agitation after desflurane anesthesia for patients undergoing a cleft lip repair surgery in children.

Methods

Twenty-one American Society of Anesthesiology Classification (ASA) Ⅰ orⅡchildren, scheduled for elective cleft lip repair surgery under general anesthesia, were enrolled in the study. After general anesthesia induction, dexmedetomidine was administered before surgery. Emergence agitation (EA) (agitation measured at level 4 or more at least once) was assessed on arrival in the postanesthetic care unit (PACU) , 15 min later, and 30 min later. The dose of dexmedetomidine for consecutive patients was determined by the response of the previous patient, using an increment or decrement of 0.1 mcg/kg.

Results

The 50% effective dose of dexmedetomidine for prevention of EA was 0.27 mcg/kg (95% CI: 0.16-0.36 mcg/kg) , and the 95% effective dose was 0.39 mcg/kg (95% CI: 0.29-0.45 mcg/kg) .

Conclusions

Dexmedetomidine can effectively prevent children′s emergence agitation after cleft lip repair surgery by desflurane anesthesia. Further study is needed to validate the suggested dose of dexmedetomidine to prevent the EA that was identified in the present study.

Key words: Infant, Children, Cleft lip, Desflurane, Dexmedetomidine, Emergence agitation

Junxiang Huang, Hang Tian, Wei Wei, Bilian Li, Xingrong Song, Yingqiu Cui, Zhe Mao. Effective dose of dexmedetomidine for the prevention of emergence agitation after desflurane anesthesia for cleft lip repair surgery in children[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2016, 10(05): 343-346.

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URL: https://zhkqyxyjzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1366.2016.05.008

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Figures/Tables 5

References 16

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评分	行为
1	入睡
2	清醒，安静
3	易怒，哭泣
4	不能被安慰的哭泣
5	烦躁不安，定向障碍

评分	行为
1	入睡
2	清醒，安静
3	易怒，哭泣
4	不能被安慰的哭泣
5	烦躁不安，定向障碍

评分	面部表情	腿	活动	哭	安慰
0	微笑	放松体位	静卧、活动自如	无哭声	无需安慰
1	偶尔皱眉、淡漠	紧张、不安静	来回动、辗转反侧	呻吟、呜咽	轻拍可安慰
2	下颌颤抖、紧咬牙关	有上抬和踢达动作	身体屈曲、僵直	持续大哭、尖叫	很难抚慰

评分	面部表情	腿	活动	哭	安慰
0	微笑	放松体位	静卧、活动自如	无哭声	无需安慰
1	偶尔皱眉、淡漠	紧张、不安静	来回动、辗转反侧	呻吟、呜咽	轻拍可安慰
2	下颌颤抖、紧咬牙关	有上抬和踢达动作	身体屈曲、僵直	持续大哭、尖叫	很难抚慰

组别	男/女（例）	年龄（月龄）	体重 (kg)	手术时间 (min)	麻醉时间 (min)	呼末地氟烷浓度（%，±s）	苏醒时间 (min)	PACU停留时间 (min)
无躁动患儿	3/9	10(6 ~ 24)	8(6 ~ 14)	36.0(34.2 ~ 45.0)	52.0(47.2 ~ 60.7)	6.2 ± 0.9	8.0(7.0 ~ 9.0)	32.0(27.0 ~ 34.0)
躁动患儿	2/7	9(6 ~ 22)	9(6 ~ 14)	32.0(28.0 ~ 40.5)	50.0(47.0 ~ 57.5)	6.3 ± 1.0	8.2(6.3 ~ 10.0)	39.0(34.0 ~ 42.5)
P值	0.58	0.69	0.79	0.62	0.56	0.78	0.73	0.006

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