Effect of intravenous different drugs on the prevention of restlessness during recovery period of pediatric laparoscopic surgery: a randomized control trial.
Zhi-Jie Liang, Jia-Mei Liang, Xiao-Ling Nong, Ni-Qiao Chen, An-Yuan Liu, Xiao-Qiang Sun, Yi-Xing Lu, Zhuo-Xin Ou, Sheng-Lan Li, Yu-Nan Lin
Journal of anesthesia February 1, 2025 DOI: 10.1007/s00540-024-03410-9 via PubMed
Summary
AI-generated from the abstractIn children aged 1 to 7 years undergoing laparoscopic surgery, a single dose of either 1 μg/kg dexmedetomidine or 0.3 mg/kg esketamine given at the end of carbon dioxide pneumoperitoneum reduces the incidence of emergence agitation compared to saline. Emergence agitation occurred in 8.8% of the dexmedetomidine group and 11.8% of the esketamine group, versus 35.5% with saline. Recovery time and extubation time were longer with dexmedetomidine (about 41 and 43 minutes) than with saline (about 33 minutes for both), but time in the post-anesthesia care unit did not differ significantly among the groups.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 102 |
| Population | Children aged 1 to 7 years undergoing laparoscopic surgery |
| Interventions | Dexmedetomidine Esketamine |
| Dose | 1 μg/kg dexmedetomidine, 0.3 mg/kg esketamine |
| Topics | Esketamine |
| Keywords | Dexmedetomidine Emergence agitation Children's surgery Child surgery |
| Citations | 4 |
| Key finding | Both 1 μg/kg dexmedetomidine and 0.3 mg/kg esketamine reduce emergence agitation incidence after pediatric laparoscopic surgery without prolonging PACU stay. |
Abstract
To explored the impact of dexmedetomidine and esketamine in mitigating restlessness during the postoperative recovery phase following laparoscopic surgery in children. 102 individuals aged 1 to 7 years experiencing laparoscopic surgery were randomly allocated into three groups, each accepting 1 μg/kg of dexmedetomidine, 0.3 mg/kg of esketamine, or saline immediately at the end of carbon dioxide pneumoperitoneum. Emergence agitation (EA) occurrence was assessed by PAED scale and 5-point agitation scale. Pain was judged using Face, Legs, Activity, Cry, and Consolability (FLACC) scale. The recovery time, extubation time, and post-anesthesia care unit (PACU) stay time were recorded for all three groups. Patients administered 1 μg/kg of dexmedetomidine (8.8%) and individuals given 0.3 mg/kg of esketamine (11.8%) showed lower incidences of emergence agitation compared to those receiving saline (35.5%; P = 0.009). There was no statistically significant difference in the time to discharge from the PACU among the three groups of patients (P > 0.05). The recovery time and extubation time were notably extended in the dexmedetomidine group (40.88 ± 12.95 min, 42.50 ± 13.38 min) when compared to the saline group (32.56 ± 13.05 min, 33.29 ± 11.30 min; P = 0.009, P = 0.010). Following CO2 pneumoperitoneum in pediatric laparoscopic surgeries, the intravenous administration of 1 μg/kg dexmedetomidine or 0.3 mg/kg esketamine effectively lowers EA occurrence without extending PACU time.