Efficacy of dexmedetomidine on postoperative analgesia & sedation in children undergoing adenotonsillectomy

Abstract

Background: Adenotonsillectomy is a common surgical procedure in pediatric population, but post-operative pain management is a challenging concern for anaesthetist. The present study was designed to assess the efficacy of dexmedetomidine on post-operative sedation and analgesia in paediatric cases undergoing adenotonsillectomy. Materials and methods: A total 80 pediatric cases undergoing adenotonsillectomy between age group 4-9 years belong to ASA grade I and II were recruited. Study consists of two groups i.e. group 1 with 1mcg/kg Dexmeditomidine and group 2 with 2 mcg/kg fentanyl. Parameters like heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), requirement of post-operative analgesia and sedation assessed by Ramsay sedation score & CHEOPS score and emergence agitation were assessed. Results: The mean heart rate was significant between two study groups at the beginning, 5 min, 15 min, 20 min and at 25 min (p<0.005). The mean SBP in group 1 was high at the beginning, later the values were decreased when compared group 2. However, the mean DBP in group 1 was low when compared to the group 2 at all-time intervals. The mean Ramsay sedation score difference was statistically significant among two study groups at the beginning, 5 min, 10 min, 15 min and 45 min (p<0.005). The requirement of additional rescue doses were noticed more in group 2. Conclusion: Dexmedetomidine was effective in maintaining intraoperative heart rate, systolic blood pressure and diastolic blood pressure. Dexmedetomidine is an effective and safe analgesic substitute to fentanyl intra-operatively and reduces the requirement of postoperative rescue opioid. Dexmedetomidine was more effective in preventing emergence agitation, avoiding severe pain and reducing incidence of postoperative nausea and vomiting.