What are the effects of perioperative dexmedetomidine as an adjuvant to tonsillectomy compared with opioid or sham in children?
Perioperative administration of dexmedetomidine can provide pain and agitation relief without side effects in children undergoing adenotonsillectomy.
Explore this issue:May 2018
Background: Tonsillectomy is one of the most common surgical procedures performed in children under general anesthesia. However, many patients suffer from postoperative problems such as emergence agitation (EA) and pain. Emergence agitation presents as combative movements, excitability, thrashing, disorientation, and inconsolable crying during recovery and is encountered in up to 80% of children who have received inhalational anesthetics. Dexmedetomidine, an alpha-2 adrenoceptor agonist, has sympatholytic, sedative, anesthetic, and algesic effects and, recently, has been used in pediatrics as a premedication, a sedation agent, an adjunct to inhaled anesthetic agents, and a drug for both prophylaxis and treatment of EA. Evidence in the existing literature is insufficient to fully support the its use in children.
Study design: Five databases (PubMed, SCOPUS, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) were searched.