Dexmedetomidine versus fentanyl in anesthesia of cochlear implantation in pediatric patients

Saied, Mohamed H.; Mohamed, Nashwa Nabil; Mohamed, H.; Amin, Mohamed A.

doi:10.1016/j.egja.2015.09.016

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…It allowed rapid recovery from anesthesia and reduced need for pain medication in the PACU. [ 15 ] These findings correlate with the present study.…”

Section: Discussionsupporting

confidence: 93%

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Dexmedetomidine versus magnesium sulfate in anesthesia for cochlear implantation surgery in pediatric patients

Hassan

Saleh

2017

Anesth Essays Res

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Context:Cochlear implantation surgery represents a great advance in ENT surgeries. Special anesthetic managements were required to provide bloodless surgical field and monitoring of the facial nerve.Aims:We aimed to compare both dexmedetomidine and magnesium sulfate as regards their efficacy in inducing deliberate hypotension and providing better quality of the surgical field during cochlear implantation in pediatrics.Settings and Design:Prospective, randomized double-blinded study.Subjects and Methods:Forty-six pediatric patients aging 1.5–2.5 years of either sex with American Society of Anesthesiologists physical status classes I and II were randomized into dexmedetomidine (D) group (n = 23) and magnesium sulfate (M) group (n = 23). In the D group, after induction of anesthesia but before the surgery, a bolus dose of 0.4 μg/kg slowly infused over 10 min, then continuous infusion by a rate of 0.4 μg/kg/h until the end of surgery. In M group, after induction of anesthesia but before the surgery, magnesium sulfate 10% (50 mg/kg) was given slowly, then continuous infusion by a rate of 10 mg/kg/h during the whole surgery. Intraoperative hemodynamics, quality of surgical field, fentanyl consumption, blood loss, operative time, FLACC pain scores, and adverse effects were compared in both groups.Statistical Analysis Used:Data were presented as mean ± standard deviation, ranges, numbers, and percentages as appropriate. Comparison of demographic data and time of surgery was done by Student's t-test. Two-way analysis of variance with correction for repeated measurements was used for heart rate and blood pressure comparison. Mann–Whitney U-test was used for nonparametric measurements.Results:Surgical field score and blood loss were better in D group than M group. Fentanyl consumption was less in D group than M group. Heart rate and mean atrial blood pressure were lower in D group except in the initial times than M group.Conclusions:In our study, both drugs were effective in achieving hypotensive anesthesia in pediatrics; however, dexmedetomidine proved to have superior effect on the surgical field and blood loss compared to magnesium sulfate with no intra- and post-operative complications for cochlear implantation surgery.

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“…It allowed rapid recovery from anesthesia and reduced need for pain medication in the PACU. [ 15 ] These findings correlate with the present study.…”

Section: Discussionsupporting

confidence: 93%

“…Moreover, the intraoperative reduction in hemodynamic parameters (MAP and HR) in both groups was within 20% from baseline values. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

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Dexmedetomidine versus magnesium sulfate in anesthesia for cochlear implantation surgery in pediatric patients

Hassan

Saleh

2017

Anesth Essays Res

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“…In line with our result, El Saied et al reported that dexmedetomidine infusion in pediatric patients allowed rapid recovery from anesthesia and reduced need for analgesic requirements in the postoperative period [36].…”

Section: Discussionsupporting

confidence: 80%

Controlled Hypotensive Anesthesia in Children Undergoing Nasal Surgery

Amin¹,

Elmawy²

2016

J Anesth Clin Res

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Background: The nasal surgery in pediatric patient's caries a major challenge to both anesthesiologist and surgeon. The surgeon faces small nostrils and narrow nasal passages. The anesthesiologist has to produce condition which facilitate the surgery, decrease the operative time by minimize the intraoperative bleeding to allow better visualization this can be achieved by controlled hypotensive anesthesia which is the key issue in the success of nasal surgery in pediatric age group.

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“…El Saied MH found that, Dexmedetomidine infusion in cochlear implantation in pediatric patients was better in inducing deliberate hypotension and providing better quality scale of surgical field compared to fentanyl infusion. It allowed rapid recovery from anesthesia and reduced need for pain medication in the PACU [28].…”

Section: Discussionmentioning

confidence: 99%

Optimizing surgical field during cochlear implant surgery in children: Dexmedetomidine versus Esmolol

Amin

Elmawy

2016

Egyptian Journal of Anaesthesia

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Background: The field of cochlear implantation has been expanding rapidly and it has been hailed as one of the greatest advances in otology. The technique of anesthesia plays a crucial role in success of cochlear implant surgery as the anesthesiologist has to produce conditions which facilitate surgery by inducing bloodless operative field. Study objective: To determine the efficacy of dexmedetomidine versus esmolol usage as an adjunct to induce controlled hypotension in children undergoing cochlear implant surgery. Design: Clinical trial study. Setting: Operating room in a university hospital. Patients: 70 children aged 2-4 years scheduled for cochlear implant surgery under general anesthesia. Patients were randomly allocated according to drugs used into two equal groups (35 patients in each group). Interventions: Group (D): The patients in this group received a bolus dose of dexmedetomidine 0.5 ug/kg over 10 min followed by continuous infusion 0.2-0.5 ug/kg/h after induction of anesthesia but before surgery. Group (E): The patients in this group received a bolus dose of esmolol 0.5 mg/kg over 10 min followed by continuous infusion 100-300 ug/kg/min after induction of anesthesia but before surgery. Measurements: Heart rate, Mean Arterial blood Pressure, Quality of surgical field, operative time, adverse events. Main results: The quality of surgical field was comparable between both groups in all times of measurements. The time to first analgesic request was statistically significant longer in group (D) than in group (E) and the total tramadol consumption was statistically significant less in group (D) than in group (E). Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

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Dexmedetomidine versus fentanyl in anesthesia of cochlear implantation in pediatric patients

Cited by 10 publications

References 17 publications

Dexmedetomidine versus magnesium sulfate in anesthesia for cochlear implantation surgery in pediatric patients

Dexmedetomidine versus magnesium sulfate in anesthesia for cochlear implantation surgery in pediatric patients

Controlled Hypotensive Anesthesia in Children Undergoing Nasal Surgery

Optimizing surgical field during cochlear implant surgery in children: Dexmedetomidine versus Esmolol

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