Effect of dexmedetomidine on emergence agitation in children undergoing adenotonsillectomy under sevoflurane anesthesia: A randomized controlled study

Abstract

Background: Emergence agitation is a frequent postoperative problem in pediatric patients undergoing adenotonsillectomy. The incidence of EA is wide ranging in the literature from 10% to 80%. Objective: The aim of this study was to assess the effect of dexmedetomidine in decreasing emergence agitation associated with sevoflurane in children after adenotonsillectomy. Design: A prospective randomized study. Setting: King Fahad military hospital, Saudi Arabia. Methods: The study included 150 patients, classified randomly into two groups and received either sevoflurane or sevoflurane with dexmedetomidine. The Pediatric Anesthesia Emergence Delirium Scale (PAED) was used to assess the emergence agitation. If the PAED scale was ⩾16, the patient was considered agitated. Results: The incidence of emergence agitation was 29 patients in group A (38.66%) and 6 patients (8%) in group B (P < 0.001). Also the comparison of incidence time of agitation, nausea and vomiting and time of discharge from post-anesthesia care unit between the two groups was significant (P < 0.05). Conclusion: Dexmedetomidine decreased significantly the incidence of agitation with sevoflurane in pediatric patients undergoing adenotonsillectomy and it was associated with a shorter time to extubation, lower incidence of postoperative nausea and vomiting and shorter post-anesthesia care unit length of stay.