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Effect of intravenous different drugs on the prevention of restlessness during recovery period of pediatric laparoscopic surgery: a randomized control trial.

Zhi-Jie Liang, Jia-Mei Liang, Xiao-Ling Nong, Ni-Qiao Chen, An-Yuan Liu, Xiao-Qiang Sun, Yi-Xing Lu, Zhuo-Xin Ou, Sheng-Lan Li, Yu-Nan Lin

Journal of anesthesia February 1, 2025 DOI: 10.1007/s00540-024-03410-9 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 102
Population Children aged 1 to 7 years undergoing laparoscopic surgery
Interventions Dexmedetomidine Esketamine
Dose 1 μg/kg dexmedetomidine, 0.3 mg/kg esketamine
Topics Esketamine
Keywords Dexmedetomidine Emergence agitation Children's surgery Child surgery Post-surgery recovery Emergence from anesthesia Surgical restlessness
Citations 4
Key findings Both 1 μg/kg dexmedetomidine and 0.3 mg/kg esketamine reduce emergence agitation incidence after pediatric laparoscopic surgery without prolonging PACU stay.

Abstract

To explored the impact of dexmedetomidine and esketamine in mitigating restlessness during the postoperative recovery phase following laparoscopic surgery in children. 102 individuals aged 1 to 7 years experiencing laparoscopic surgery were randomly allocated into three groups, each accepting 1 μg/kg of dexmedetomidine, 0.3 mg/kg of esketamine, or saline immediately at the end of carbon dioxide pneumoperitoneum. Emergence agitation (EA) occurrence was assessed by PAED scale and 5-point agitation scale. Pain was judged using Face, Legs, Activity, Cry, and Consolability (FLACC) scale. The recovery time, extubation time, and post-anesthesia care unit (PACU) stay time were recorded for all three groups. Patients administered 1 μg/kg of dexmedetomidine (8.8%) and individuals given 0.3 mg/kg of esketamine (11.8%) showed lower incidences of emergence agitation compared to those receiving saline (35.5%; P = 0.009). There was no statistically significant difference in the time to discharge from the PACU among the three groups of patients (P > 0.05). The recovery time and extubation time were notably extended in the dexmedetomidine group (40.88 ± 12.95 min, 42.50 ± 13.38 min) when compared to the saline group (32.56 ± 13.05 min, 33.29 ± 11.30 min; P = 0.009, P = 0.010). Following CO2 pneumoperitoneum in pediatric laparoscopic surgeries, the intravenous administration of 1 μg/kg dexmedetomidine or 0.3 mg/kg esketamine effectively lowers EA occurrence without extending PACU time.

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