Ravi Bhat, Mahantesh Mudukanagoudar, Sandeep Shetty, Shyamsundar Kamath.
Study of dose related effects of dexmedetomidine on laryngeal mask airway removal in children -a double blind randomized study.
Anesth Pain Intens Care Jan ;23(3):368-73.

Background and objective: Respiratory complications during removal of airway device and postoperative agitation are commonly experienced problems in pediatric anesthesia. Dexmedetomidine being a potent ?2 adrenergic receptor agonist has the capability to circumvent this problem. This study was designed to evaluate efficacy of two doses of dexmedetomidine on laryngeal mask airway removal. Methodology: Ninety children of 1 to 8 years were recruited for this randomized double blind study. The patients were randomly allocated into three groups and received either normal saline (Group S), dexmedetomidine 0.5 µg /kg (Group D0.5) or dexmedetomidine 1 µg /kg (Group D1) with 30 patients in each group. Anesthesia was induced with Sevoflurane in oxygen. All patients received intravenous fentanyl 1?g/kg followed by caudal block. LMA of appropriate size was inserted when jaw relaxation was adequate and then 5 ml of the study drug was administered over 10 minute. LMA removal was assessed according to preset criteria. Assessment of emergence agitation was done using Aonos four point scale. Result: Incidence of smooth LMA removal was significantly more in Group D1 compared to Group S (p = 0.0001) and in Group D1 compared to Group D0.5 (p = 0.0020) but difference was not significant between Group D0.5 and Group S (p = 0.1142).Patients who did not have emergence agitation was significantly more in Group D0.5 (p = 0.05) and Group D1 (p = 0.0001) compared to Group S and also in Group D1 compared to Group D0.5 (p = 0.0102). Conclusion: A single dose of dexmedetomidine 1 µg /kg provides better conditions for smooth removal of laryngeal mask airway in children. Dexmedetomidine 1 µg /kg is more effective than 0.5 µg /kg in reducing emergence agitation.

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