Study of dose related effects of dexmedetomidine on laryngeal mask airway removal in children -a double blind randomized study

Abstract

Background and objective: Respiratory complications during removal of airway device and postoperative agitation are commonly experienced problems in pediatric anesthesia. Dexmedetomidine being a potent α2 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 D_0.5) 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 1μg/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 D₁compared to Group D_0.5 (p = 0.0020) but difference was not significant between Group D_0.5 and Group S (p = 0.1142).Patients who did not have emergence agitation was significantly more in Group D_0.5 (p = 0.05) and Group D₁ (p = 0.0001) compared to Group S and also in Group D₁ compared to Group D_0.5 (p = 0.0102).