الفهرس 
Pediatric AnesthesiaOnly 14 pages are availabe for public view
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Abstract
Abstract
Background: Emergence agitation (EA) in children early after sevoflurane anesthesia is a common postoperative problem, with incidence ranging up to 80%, It is characterized by behavior that can include crying, disorientation, excitation and delirium, Sevoflurane in particular has been associated with an increased amount of agitation on emergence.
Objective: The aim of this study is to compare the effect of dexmedetomidine and midazolam administrated intraoperatively on emergence agitation in children receiving sevoflurane.
Methods: This randomized, double-blind, clinical study enrolled 100 pediatric patients undergoing inguinal hernia repair, hydrocele, orcheopexy at Ain Shams university educational hospital, patients were randomly allocated in a 1:1 ratio into 1 of 2 groups: The Dexamethasone group (group D) patients received IV 0.2μg/kg dexmedetomidine, and the Midazolam group (group M) patients received IV 40μg/kg midazolam. After baseline measurements, Heart rate (HR), mean arterial blood pressure (MAP), arterial oxygen saturation (SpO2) were recorded every 5 minutes, at end of surgery sevoflurane was discontinued and the trachea was extubated, and time to eye opening was calculated, postoperative assessment of Adequacy of recovery using a Modified Alderte score pain was evaluated using Face, Leg, Activity, Cry, Consolability (FLACC) score and behavior was assessed with Five-step Emergence Agitation scale, time to discharge from Post-anesthesia care unit upon reaching a modified Aldrete score of > 8 was calculated, HR, MAP, Spo2 were recorded.
Results: Administration of dexmedetomidine was associated with more decrease in HR and mean arterial blood pressure, higher oxygen saturation postoperatively, also patients who received dexmedetomidine showed more rapid eye opening and less time till discharge from PACU and a higher Aldrete score and a lower emergence agitation score 24% vs 12% in midazolam group while no significant difference between both groups as regard the pain score FLACC.
Conclusion: We found that a single dose Dexmedetomidine (0.2 µg/kg) reduces risk of EA to a greater extent than a single dose of midazolam (40 µg/kg) 12% vs 24% respectively, Dexmedetomidine was associated with higher oxygen saturation, more decrease in HR and mean arterial blood pressure blood pressure than midazolam.
Key words: sevoflurane, dexmedetomidine, midazolam, emergence agitation.