The effect of two different doses of dexmedetomidine to prevent emergence agitation in children undergoing adenotonsillectomy：a randomized controlled trial
O efeito de duas doses diferentes de dexmedetomidina para prevenir a agitação ao despertar em crianças submetidas à adenotonsilectomia: um ensaio clínico randomizado
Wenjing Yi, Jie Li, Yan Zhuang, Lichun Wan, Wenxian Li, Jie Jia
Abstract
Objective
To evaluate different doses of dexmedetomidine for the prevention of emergence agitation in children undergoing adenotonsillectomy.
Method
130 children aged 3-10 years scheduled for adenotonsillectomy were randomly assigned to two groups. Anesthesia was induced with 0.5 μg.kg-1 dexmedetomidine (DEX 0.5 group) or 1 μg.kg-1 dexmedetomidine (DEX 1 group) at the beginning of surgery. Observers who recorded the data in the post-anesthesia care unit were blinded to the allocation. The primary outcome was the percentage of emergence agitation. The times to spontaneous breath, awake, extubate, and post anesthesia care unit stay were also recorded.
Results
124 children were randomized into two groups. 5 children were excluded because of adverse events and dropout (DEX 0.5 group, n = 58; DEX 1 group, n = 62). No significant differences were noted in the percentage of emergence agitation between the two groups. The times to extubation(p = 0.003), awake and post-anesthesia care unit stay in DEX 0.5 group were shorter than those in DEX 1 group (p < 0.0001). There was no significant difference between the two groups in the time to spontaneous breath. Approximately 8% of patients in DEX 0.5 group and 18% patients in DEX 1 group presented low SpO2, showing a significant difference between the two groups (p = 0.043).
Conclusions
0.5 μg.kg-1 dexmedetomidine was equally effective as 1 μg.kg-1 dexmedetomidine in preventing emergence agitation.
Trial registration
: The trial is currently completed recruitment, registered in ClinicalTrials.gov (ID:NCT03760809). Inclusion began on 4 January, 2019.
Keywords
Resumo
Objetivo: Avaliar diferentes doses de dexmedetomidina na prevenção da agitação ao despertar em crianças submetidas à adenotonsilectomia.
Método: Cento e trinta crianças de 3 a 10 anos agendadas para adenotonsilectomia foram divididas aleatoriamente em dois grupos. A anestesia foi induzida com 0,5 μg.kg-1 de dexmedetomidina(Grupo DEX 0,5) ou 1 μg.kg-1 de dexmedetomidina (grupo DEX 1) no início da cirurgia. Os observadores que registraram os dados na unidade de recuperação pós-anestésica desconheciam a alocação. O desfecho primário foi a porcentagem de agitação ao despertar. Os tempos de respiração espontânea, despertar, extubar e permanência na unidade de recuperação pós-anestésica também foram registrados.
Resultados: Cento e vinte e quatro crianças foram randomizados em dois grupos. Cinco crianças foram excluídas devido a eventos adversos e abandono (grupo DEX 0,5, n = 58; grupo DEX 1, n = 62). Não foram observadas diferenças significativas na porcentagem de agitação ao despertar entre os dois grupos. Os tempos de extubação (p = 0,003), vigília e permanência na unidade de recuperação pós-anestésica no grupo DEX 0,5 foram menores do que no grupo DEX 1 (p <0,0001). Não houve diferença significante entre os dois grupos no tempo até a respiração espontânea. Aproximadamente 8% dos pacientes do grupo DEX 0,5 e 18% dos pacientes do grupo DEX 1 apresentaram SpO2 baixa, mostrando diferença significativa entre os dois grupos (p = 0,043).
Conclusões: Uma dose de 0,5 g.kg-1 de dexmedetomidina foi tão eficaz quanto 1 μg.kg-1 de dexmedetomidina na prevenção da agitação ao despertar.
Palavras-chave
References
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Submitted date:
11/16/2019
Accepted date:
08/07/2021
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