Dexmedetomidine Effect on Emergence Agitation and Delirium in Children Undergoing Laparoscopic Hernia Repair: a Preliminary Study

Sun, Yingying; Li, Yuanhai; Sun, Yi; Wang, Xing; Ye, Hongwu; Yuan, Xianren

doi:10.1177/0300060517699467

Cited by 22 publications

(42 citation statements)

References 28 publications

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“…A total of 24 RCTs were included in the present meta-analysis. [4][5][6][7][8][9][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] The results showed that, compared with placebo, Dex was associated with positive effects on recovery quality in children undergoing general anaesthesia with sevoflurane, reducing nausea and vomiting and shortening the eye-opening time, extubation time, and duration of PACU stay. Unlike the present study, Amorim et al 10 reported that Dex reduced the incidence of emergence agitation while prolonging the duration of PACU stay and eye-opening time.…”

Section: Discussionmentioning

confidence: 99%

“…Subgroup analysis revealed that sample size was the main source of heterogeneity (Table 3). Thirteen RCTs reported the eye-opening time, 5,7,9,14,15,18,19,24,25,28,29 I 2 ¼ 79.9% (P < 0.001), and these were combined using a random-effects model. Dex was found to be associated with reduced eyeopening time versus placebo (SMD 0.72, 95% CI 0.41, 1.03; P < 0.001; Figure 6 and Table 2).…”

Section: Quantitative Synthesismentioning

confidence: 99%

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Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review

Wen

Liu

2020

J Int Med Res

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Objective The sedative effects of dexmedetomidine (Dex) are similar to natural sleep, with easy wakening following Dex administration, and Dex has minor effects on breathing, reducing emergence agitation in children. The aim of this study was to systematically evaluate the effects of Dex on recovery quality in children following general anaesthesia with sevoflurane, to aid clinical decision making. Methods Relevant randomized controlled trials published before August 2019 were searched and selected from databases. Two researchers independently screened the literature, extracted data, and assessed included studies for bias risk. Meta-analysis was performed using Stata 14.0 software. Results The study included 24 publications. Following general anaesthesia by sevoflurane, Dex was associated with reduced occurrence of emergence agitation (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.11, 0.25) and nausea and vomiting (OR 0.40, 95% CI 0.24, 0.60), along with shortened eye-opening time (standardized mean difference [SMD] 0.72, 95% CI 0.41, 1.03), shortened extubation time (SMD 0.54, 95% CI 0.28, 0.81), and reduced duration of post-anaesthesia care unit (PACU) stay (SMD 0.29, 95% CI 0.08, 0.51) versus placebo. Conclusion Dexmedetomidine has positive effects on recovery quality in children undergoing general anaesthesia with sevoflurane.

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Section: Discussionmentioning

confidence: 99%

Section: Quantitative Synthesismentioning

confidence: 99%

Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review

Wen

Liu

2020

J Int Med Res

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“…In general cerebral oxygenation is an important consideration in neonatal medicine. A number of clinical reports indicate that a fraction of inspired oxygen (FiO 2 ) ranging from 0.3 to 1.0 may be used in pediatric practice (for example, (Ahiskalioglu et al, 2017; Mohamed, 2015; Sun et al, 2017; von Bormann et al, 2014; William et al, 2001)) depending upon the circumstances. However, in neonatal and pediatric anesthesia, the use of supplemental oxygen is common in order to avoid hypoxia, as has been described in a number of reviews (Bang, 2015; Dikmen and Onur, 2017; Sola, 2008).…”

Section: Discussionmentioning

confidence: 99%

Brain tissue oxygen regulation in awake and anesthetized neonates

Aksenov¹,

Dmitriev²,

Miller³

et al. 2018

Neuropharmacology

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Inhaled general anesthetics are used commonly in adults and children, and a growing body of literature from animals and humans suggests that exposure to anesthesia at an early age can impact brain development. While the origin of these effects is not well understood, it is known that anesthesia can disrupt oxygen regulation in the brain, which is critically important for maintaining healthy brain function. Here we investigated how anesthesia affected brain tissue oxygen regulation in neonatal rabbits by comparing brain tissue oxygen and single unit activity in the awake and anesthetized states. We tested two common general anesthetics, isoflurane and sevoflurane, delivered in both air and 80% oxygen. Our findings show that general anesthetics can greatly increase brain tissue PO in neonates, especially when combined with supplemental oxygen. Although isoflurane and sevoflurane belong to the same class of anesthetics, notable differences were observed in their effects upon neuronal activity and spontaneous respiration. Our findings point to the need to consider the potential effects of hyperoxia when supplemental oxygen is utilized, particularly in children and neonates.

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“…315 potentially relevant articles are identi ed initially. Finally, six RCTs are included in the meta-analysis [11,13,[17][18][19]25].…”

Section: Resultsmentioning

confidence: 99%

“…The dose of dexmedetomidine ranged from 0.3 µg/kg to 1.0 µg/kg. Among the six included RCTs, two trials reported analgesic consumption [19,25], two trials reported number of rescue analgesics and time to rst analgesia [18,19], two trials reported emergence agitation [18,25], as well as two trials reported pain scores at 1 h and 2 h [17,19]. Jadad scores of the six included studies vary from 3 to 5, and all six studies have high-quality based on the quality assessment.…”

Section: Resultsmentioning

confidence: 99%

Dexmedetomidine Addition For Pediatric Hernia Repair: A Meta-Analysis of Randomized Controlled Studies

Liu¹,

Liu²,

Liang³

2020

Preprint

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Introduction: The efficacy of dexmedetomidine addition for pain control after pediatric hernia repair remains controversial. We conduct a systematic review and meta-analysis to explore the influence of dexmedetomidine addition on pain management for pediatric hernia repair.Methods: We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2020 for randomized controlled trials (RCTs) assessing the effect of dexmedetomidine addition on pain management for pediatric hernia repair. This meta-analysis is performed using the random-effect model.Results: Six RCTs are included in the meta-analysis. Overall, compared with control group for pediatric hernia repair, dexmedetomidine addition is associated with significantly reduced analgesic consumption (SMD=-1.0; 95% CI=-1.40 to -0.61; P<0.00001) and number of rescue analgesics (SMD=0.16; 95% CI=0.06 to 0.41; P=0.0002), prolonged time to first analgesia (SMD=8.16; 95% CI=4.58 to 11.73; P<0.00001) and decreased the incidence of emergence agitation (RR=0.12; 95% CI=0.03 to 0.44; P=0.001), but has no obvious impact on pain scores at 1 h (SMD=-2.00; 95% CI=-5.78 to 1.79; P=0.30) or 2 h (SMD=-0.73; 95% CI=-2.33 to 0.87; P=0.37).Conclusions: Dexmedetomidine addition is beneficial to pain control after pediatric hernia repair.

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Dexmedetomidine Effect on Emergence Agitation and Delirium in Children Undergoing Laparoscopic Hernia Repair: a Preliminary Study

Cited by 22 publications

References 28 publications

Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review

Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review

Brain tissue oxygen regulation in awake and anesthetized neonates

Dexmedetomidine Addition For Pediatric Hernia Repair: A Meta-Analysis of Randomized Controlled Studies

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