Effect of dexmedetomidine in children undergoing general anesthesia with sevoflurane

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SCIENCE
Effect of dexmedetomidine in children undergoing general anesthesia with sevoflurane
Key Take-Away: 

Sevoflurane is a potential anesthetic used in pediatric patients, but its administration can lead to agitation in children. However, this agitation can be minimized with the help of medications. 

Sevoflurane is often used in pediatric anesthesia and is associated with high incidence of psychomotor agitation.

ABSTRACT: 
Background: 

Sevoflurane is often used in pediatric anesthesia and is associated with high incidence of psychomotor agitation. In such cases, dexmedetomidine (DEX) has been used, but its benefit and implications remain uncertain.

The presented study assessed the effects of DEX on agitation in children undergoing general anesthesia with sevoflurane.

Methods: 

Meta-analysis of randomized clinical and double-blind studies, with children undergoing elective procedures under general anesthesia with sevoflurane, using DEX or placebo was conducted.

The articles in English were searched in PubMed database using the terms Dexmedetomidine, sevoflurane (Methyl Ethers/sevoflurante), and agitation (Psychomotor Agitation). Duplicate articles with children who received premedication and used active control were excluded. Random effects model with DerSimonian-Laird testing and odds ratio (OR) calculation for dichotomous variables, and the standardized mean difference for continuous variables, with their respective 95% CI were adopted.

Results: 

Of 146 studies identified, 10 were selected totaling 558 patients (282 in DEX group and 276 controls).

The use of DEX was considered a protective factor for psychomotor agitation (OR=0.17; 95% CI 0.13-0.23; p< 0.0001) and nausea and vomiting in PACU (OR = 0.49; 95% CI 0.35-0.68; p< 0.0001). Wake-up time and PACU discharge time were higher in the dexmedetomidine group. There was no difference between groups for extubation time and duration of anesthesia.

Conclusion: 

Dexmedetomidine reduces psychomotor agitation during the wake-up time of children undergoing general anesthesia with sevoflurane.

 

Source:

Revista Brasileira de Anestesiologia

Link to the source:

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942017000200193&lng=en&nrm=iso&tlng=en

The original title of the article:

Effect of dexmedetomidine in children undergoing general anesthesia with sevoflurane: a meta-analysis

Authors:

Marco Aurélio Soares Amorim et al.

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