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IntroductionEmergence agitation remains a problem that occurs in pediatric anesthesia. As cleft surgeries constitute one of the most common craniofacial surgeries encountered, majority of the children receive general anesthesia using high dose opioids and inhalation anesthetics and experience emergence agitation. Dexmedetomidine (DEX), an alpha-2 adrenoreceptor agonist possesses anxiolytic, sedative and analgetic properties and have been documented to reduce the incidence of postoperative agitation. Hence, this study aims to compare the incidence of emergence agitation between the use of intravenous DEX versus Sevoflurane (SEVO) anesthesia.MethodsThis study selected one hundred twenty-one patients ages 3 months to 10 years with ASA 1 and 2 physical status scheduled to undergo elective cleft lip or cleft palate repair with general anesthesia. Before surgery, all patients were assessed preoperatively and subjects were divided into two groups using a computer-generated randomizer with 59 subjects selected as Dexmedetomidine group; and 62 subjects as Sevoflurane group. Extubation time, recovery time and emergence agitation scale were compared between the two groups.ResultsThis study found no significant difference in the extubation time between DEX and SEVO group (p = 0.317). The recovery time or time to attain full consciousness was statistically longer in the DEX group: 60 minutes as compared to 52 minutes in the SEVO group (p = 0.007). Emergence agitation assessed using Cravero score found that subjects from DEX group had an average Cravero score of 2.5; while SEVO group had an average Cravero score of 3.9 (p = ConclusionsDexmedetomidine significantly reduces the incidence of emergence agitation without prolonging extubation time in pediatric patients undergoing cleft lip and cleft palate surgery.
引言:苏醒期躁动仍是小儿麻醉领域亟待解决的临床难题。唇腭裂修复术是临床最常见的颅颌面手术之一,多数患儿需采用大剂量阿片类药物联合吸入麻醉剂实施全身麻醉,术后极易出现苏醒期躁动。右美托咪定(Dexmedetomidine, DEX)作为α2肾上腺素能受体激动剂,具备抗焦虑、镇静与镇痛的药理特性,已有研究证实其可降低术后躁动的发生率。因此本研究旨在对比静脉输注右美托咪定与七氟醚(Sevoflurane, SEVO)麻醉方案的苏醒期躁动发生率。 方法:本研究纳入121例年龄3个月至10岁、美国麻醉医师协会(ASA)身体状况分级为1~2级、拟择期行唇裂或腭裂修复术的全身麻醉患儿。术前对所有患儿完成评估后,通过计算机随机生成系统将受试者分为两组:右美托咪定组(59例)与七氟醚组(62例)。比较两组患儿的拔管时间、苏醒时间以及苏醒期躁动评分。 结果:本研究显示,右美托咪定组与七氟醚组的拔管时间无显著统计学差异(p=0.317)。右美托咪定组的苏醒时间(即达到完全意识状态的时长)为60分钟,显著长于七氟醚组的52分钟,差异具有统计学意义(p=0.007)。采用Cravero评分评估苏醒期躁动结果显示,右美托咪定组患儿的平均Cravero评分为2.5,七氟醚组为3.9(原文此处P值存在排版缺失)。 结论:在接受唇腭裂修复术的儿科患者中,右美托咪定可显著降低苏醒期躁动的发生率,且不会延长拔管时间。



