Abstract: Objective To investigate the effects of dexmedetomidine on adverse events during recovery period in children with obstructive sleep apnea syndrome operation. Methods One hundred and twenty ASA physical status Ⅰ-Ⅱ children, aged 2 y-6 y, undergoing general anesthesia for tonsillectomy and adenoidectomy, were randomly divided into 3 groups (n=40): group D, group M and group P. Heart rate(HR), mean arterial pressure(MAP), pulse oxygen saturation(SpO2), partial pressure of end-tidal carbon dioxide(PETCO2) and bispectral index(BIS) were monitored in all patients when arriving in the operation room, and a intravenous catheter was inserted into the peripheral vein. The children were administered with midazolam, propofol, remifentanil and rocuronium for induction, while remifentanil and propofol target-controlled infusion for maintenance. Twenty min before the end of the surgery, in group D dexmedetomidine 0.4 μg/kg and in group M midazolam 0.05 mg/kg and in group P 0.9% NaCl were infused intravenously within 10 min. HR and MAP were recorded before anesthesia(T0), before intravenous administration(T1) , 1 min(T2) and 5 min(T3) after administration, 1 min before extubation(T4), the moment(T5), 3 (T6), 5 (T7), 10 (T8), 20 min(T9) after extubation. Time to extubation and emergence, the incidence of adverse events during recovery period were recorded. Results Time to emergence in group M[(14±4) min] were significantly longer than in group D [(11±4) min] and group P[(12±4) min](P<0.05) while the modified Aldrete score after entrance into PACU(6) were significantly lower (P<0.05). HR[(95±16), (96±16), (101±17), (103±17), (101±16), (100±16), (101±17) bpm] and MAP[(73±10), (71±9), (78±10), (79±11), (77±10), (77±10), (75±10) mmHg(1 mmHg=0.133 kPa)] were significantly lower at T2-T8 in group D compared with group M and group P(P<0.05), and the incidence of laryngospasm(5%), oxygen desaturation<92%(5%) and laryngospasm score(0), cough score(1) were also significantly lower in group D (P<0.05). The incidence of breath holding in group D(12.5%) was significantly lower than in group P (P<0.05). The pediatric anesthesia emergence delirium(PAED) scale at 10 min(8 and 9), 20 min(9 and 10) and 30 min(8 and 9) after entrance into post-anesthesia care unit(PACU) were significantly lower in group D and group M compared with group P(P<0.05). Conclusions Without interfering in recovery time,dexmedetomidine infused 20 min before the end of surgery effectively reduces adverse events during recovery period in children with obstructive sleep apnea syndrome.
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