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Comparison Between Intravenous Fentanyl and Dexmedetomidine to Decrease Sevoflurane – Induced Agitation in Paediatric Patients Undergoing Lower Abdominal Surgery: A Prospective Randomized Observational Study

Mahantesh S Mudakanagoudar , Puneeth J1 , Mahantesh S Mudakanagoudar2

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Indian Journal of Anesthesia and Analgesia 6(4):p 1387-1397, July-August 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.47

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Puneeth J, Mahantesh S Mudakanagoudar. Comparison Between Intravenous Fentanyl and Dexmedetomidine to Decrease Sevoflurane – Induced Agitation in Paediatric Patients Undergoing Lower Abdominal Surgery: A Prospective Randomized Observational Study. Indian J Anesth Analg. 2019;6(4):1387-1397.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Introduction: Sevoflurane is widely used in paediatric anesthesia. It has a rapid induction and rapid recovery profile. It is pleasant, non-pungent and non irritant to the respiratory airways. Emergence agitation (EA) in children early after sevoflurane anesthesia is a common postoperative problem, with incidence up to 80%. Fentanyl and α2-agonists like Dexmedetomidine have been shown to be effective measures in decreasing the incidence of EA. Aims and Objectives: To compare the incidence of intravenous dexmedetomidine and fentanyl to decrease the post operative agitation after sevoflurane anesthesia in paediatric patients undergoing lower abdominal surgery. Material and methods: Sixty ASA physical status I and II children aged 2–9 years were included in this study. After inhalation induction with sevoflurane, patients were randomly assigned to receive either Saline (group N, n=20), fentanyl 1 mic/kg IV (group F, n=20) or dexmedetomidine 0.3 mic/kg IV (group D, n=20) 10 minutes before discontinuation of anesthesia. Results: The incidence of agitation was significantly higher in group N compared with other two groups, the incidence of agitation was 60% in Group N, 45% in Group F and 20% in Group D. There was no significant difference (p > 0.05) between the three groups in modified Aldrete recovery scores, but emergence time was more in dexmedetomidine when compared with other groups which was statistically significant. Conclusion: Fentanyl 1 mic/kg iv or dexmedetomidine 0.3 mic/kg iv that is administered 10 minutes before the termination of anesthesia reduces the postoperative agitation in children.

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Puneeth J, Mahantesh S Mudakanagoudar. Comparison Between Intravenous Fentanyl and Dexmedetomidine to Decrease Sevoflurane – Induced Agitation in Paediatric Patients Undergoing Lower Abdominal Surgery: A Prospective Randomized Observational Study. Indian J Anesth Analg. 2019;6(4):1387-1397.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.47

Keywords

Agitation; Dexmedetomidine; Fentanyl; Sevoflurane.

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