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Appropriate dose of dexmedetomidine for the prevention of emergence agitation after desflurane anesthesia for tonsillectomy or adenoidectomy in children: up and down sequential allocation

Cited 8 time in Web of Science Cited 9 time in Scopus
Authors
Kim, Hee-Soo; Byon, Hyo-Jin; Kim, Jong-Eun; Park, Yong-Hee; Lee, Ji-Hyun; Kim, Jin-Tae
Issue Date
2015-05-27
Publisher
BioMed Central
Citation
BMC Anesthesiology, 15(1):79
Keywords
ChildrenDesfluraneDexmedetomidineEmergence agitation
Description
This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited.
Abstract
Abstract

Background
Dexmedetomidine can be used for the prevention of emergence agitation (EA) in children. However, an inadequate dose of dexmedetomidine can induce prolonged sedation and cardiovascular complications. The aim of this study was to evaluate the effective dose of dexmedetomidine for the prevention of EA after desflurane anesthesia for patients undergoing a tonsillectomy or adenoidectomy.


Methods
We enrolled 21 unpremedicated children, between 2 and 12 years, undergoing either a tonsillectomy or an adenoidectomy. General anesthesia was induced using sevoflurane and oxygen, and dexmedetomidine was administered before surgery. Anesthesia was maintained using desflurane resulting in a BIS range of 40–60. In the postanesthetic care unit (PACU), EA (agitation measured at level 4 or more at least once) was assessed on arrival in the 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 μg/kg.


Results
The 50 % effective dose of dexmedetomidine for prevention of EA was 0.25 μg/kg (95 % confidence limits, 0.17–0.33 μg/kg), and the 95 % effective dose was 0.38 μg/kg (95 % confidence limits, 0.29–0.39 μg/kg).


Conclusions
For prevention of EA after desflurane anesthesia for 50 % and 95 % of children undergoing tonsillectomies or adenoidectomies, 0.25 μg/kg or 0.38 μg/kg of dexmedetomidine is suggested. Further study is needed to validate the suggested dose of dexmedetomidine to prevent the EA that was identified in the present study.


Trial registration
Clinical Research Information Service
KCT0000126

.
Language
English
URI
http://hdl.handle.net/10371/100430
DOI
https://doi.org/10.1186/s12871-015-0059-z
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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