الفهرس 
PEDIATRIC ANESTHESIAOnly 14 pages are availabe for public view
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Abstract
Abstract
Background: Anxiety and emergence delirium (ED) are common complications of anesthesia in preschool children. Several causes had been attributed to them including young age, type of procedure and separation from parents. Emergence delirium correlates to preoperative anxiety. It is unknown if surgical and non-surgical anesthesia result in similar incidence of emergence delirium or not. Premedication with dexmedetomidine would decrease the incidence and severity of these complications.
Methods: The study involved 180 children undergoing anesthesia who were randomly assigned to one of four groups, with each group containing 45 children. The study was double-blind, clinical, controlled, comparative, and prospective. Groups (A1&A2) had surgical intervention, while groups (B1&B2) had MRI scanning. Groups A1&B1 were given 20ml plain apple juice (Placebo) and groups A2&B2 received oral Dexmedetomidine (4µg/kg) inserted in 20ml apple juice 45 minutes prior to the anesthesia induction. Anxiety was assessed pre-procedural, emergence delirium and pain at different intervals post-anesthesia.
Results: Incidence of anxiety and emergence delirium showed no difference between surgical and non-surgical procedures. Patients who received oral dexmedetomidine in groups A2 and B2 had significantly lower Parental Separation Anxiety scores than corresponding control groups A1 and B1 (P=0.001). The occurrence of emergence delirium and severe pain were much decreased in groups received dexmedetomidine. PAED and FLACC exhibited significantly reduced scores in groups received dexmedetomidine than groups received Placebo drug (P<0.05) in both surgical and non-surgical procedures. Rescue analgesia was needed more significantly for patients in groups A1 and B1 relative to other groups (P=0.002). The incidence of complications revealed no statistical significance.
Conclusion: Anxiety and emergence delirium were similar in surgical and non-surgical procedures. Premedication of preschool children with oral dexmedetomidine lowered the frequency and intensity of anxiety, emergence delirium and severe pain. Emergence delirium was correlated to pain, especially in surgical procedures.