Dexmedetomidine And Ketamine For The Prevention Of Emergence Agitation In Children During Sevoflurane Anesthesia

ObjectiveTo evaluate the preventive effect of Dexmedetomidine and ketamine onemergence agitation in children during sevoflurane anesthesia.MethodsOne hundren twenty children aged1to5years old under going selectiveharelip and (or) cleft palate, American Society of Anesthesiologists [ASA] I or II,were divided into3groups,The first group: sevoflurane plus Dexmedetomidine(A,n=40),The second group: sevoflurane plus ketamine(b,n=40),The third group:sevoflurane plus physiological saline(C,n=40).The methd of anesthesiaAll patients were allowed to be present during induction, non-invasive bloodpressure,ECG and aeterial oxygen saturation were monitored.we didn’t give anymedicines before Anesthesia revulsion. Anesthesia was induced with oxygen(5L/min)plus Sevoflurane(7％), We begin to venipuncturing after disappearance of reflection.Then all patients received oroxylin(0.01mg·kg-1)、 fentanyl （1μg·kg-1）、 dexamethasone(0.1mg·kg-1）、propofol (2-3mg·kg-1)before tracheal intubation,itinserted into tracheal after disappearance of the fauces reflection. anesthesia wasmaintained with sevoflurane during the operation.oxygen turn down2L/min,Thechildren to keeping breath by himself. Childrenin the Dexmedetomidine group (A)were given0.3ug·kg-1Dexmedetomidine after venipucturing, Children in theketamine group (B) were given0.25mg·kg-1ketamine10min before surgery end,Children in the physiological saline group (C) were given5ml physiological salineduring the operating. The times of anesthesia、surgery、extubation and staying recoryroom were recorded. The comfort score before extubation and the incidence ofemergence agitation were observed in1～30minutes after extubation Adverseeffects were recorded as well.Observing ill effect:nausea、suffocate、anoxia and soon.ResultsCompare group A to group B, the data of group A is simlar to group B. there wasno significant difference during A Group and B Group at different check-point(P>0.05). The incidence of emergence agitation was higher in C Group than that in AGroup and A Group (P <0.05) at the time of5min、10min、15min、20min、25minafter extubation. there was significant difference compare A Group and B Group toC Group at different check-point (P <0.05). The satisfaction rate of the sedation inABC group were80％、50.5％、25％respectively, The satisfaction rate was muchhigher in A Group than the other Groups (P<0.05), Thesatisfaction rate wassignificantly in three groups (P <0.01). The time stay at was recocery roomsignificantly longer in C Group than that in A Group and B Group(P <0.01),therewas significant difference during A Group and B Group.ConclusionConclusion:We conclude that the addition of given0.3ug·kg-1Dexmedetomidine after venipucturing, or ketamine0.25mg·kg-1can decrease theincidence of emergence agitation in children after sevoflurane general anesthesia.