scholarly journals Dexmedetomidine for the prevention of emergence delirium and postoperative behavioral changes in pediatric patients with sevoflurane anesthesia: a double-blind, randomized trial

2019 ◽  
Vol Volume 13 ◽  
pp. 897-905 ◽  
Author(s):  
Mengzhu Shi ◽  
Shuai Miao ◽  
Tianchu Gu ◽  
Dongyue Wang ◽  
Hui Zhang ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Pediatric Patients ◽  
Behavioral Changes ◽  
Sevoflurane Anesthesia ◽  
Double Blind ◽  
Emergence Delirium

scholarly journals Changes in Plasma Glial Fibrillary Acidic Protein in Children Receiving Sevoflurane Anesthesia: A Preliminary Randomized Trial

2021 ◽  
Vol 10 (4) ◽  
pp. 662
Author(s):  
Eun-Hee Kim ◽  
Young-Eun Jang ◽  
Sang-Hwan Ji ◽  
Ji-Hyun Lee ◽  
Sung-Ae Cho ◽  
...  
Keyword(s):  
Glial Fibrillary Acidic Protein ◽  
Randomized Trial ◽  
Protein Concentration ◽  
Pediatric Patients ◽  
Neuronal Injury ◽  
Acidic Protein ◽  
Anesthesia Induction ◽  
Sevoflurane Anesthesia ◽  
Control Groups ◽  
Over Time

We investigated changes in plasma glial fibrillary acidic protein concentration during sevoflurane anesthesia induction in children < 3 years old and determined the effect of co-administering dexmedetomidine. This preliminary randomized trial included 60 pediatric patients who received sevoflurane anesthesia for >3 h. Patients were assigned to dexmedetomidine or control groups at a 1:1 ratio. The primary outcome was changes in plasma glial fibrillary acidic protein concentration of dexmedetomidine and control groups over time. Fifty-five patients were included in the final analysis. The median (interquartile range (IQR)) of the plasma glial fibrillary acidic protein level was 387.7 (298.9–510.8) pg·mL−1 immediately after anesthetic induction, 302.6 (250.9–412.5) pg·mL−1 at 30 min, and 321.9 (233.8–576.2) pg·mL−1 at 180 min after the first sample. These values did not change over time (p = 0.759). However, plasma glial fibrillary acidic protein increased after 180 min of infusion of dexmedetomidine compared with values at 30 min infusion (p = 0.04, mean difference and 95% confidence interval of 221.6 and 2.2 to 441.0 pg·mL−1). In conclusion, three hours of sevoflurane anesthesia in pediatric patients < 3 years old did not provoke neuronal injury assessed by the plasma biomarker. Further studies regarding the effect of prolonged dexmedetomidine infusion on anesthetic neuronal injury are required.

Sevoflurane versus  Halothane: Postoperative Maladaptive Behavioral Changes

2005 ◽  
Vol 102 (4) ◽  
pp. 720-726 ◽  
Author(s):  
Zeev N. Kain ◽  
Alison A. Caldwell-Andrews ◽  
Megan E. Weinberg ◽  
Linda C. Mayes ◽  
Shu-Ming Wang ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Sleep Disturbances ◽  
Controlled Trial ◽  
Postoperative Recovery ◽  
Behavioral Changes ◽  
Group Differences ◽  
Double Blind ◽  
Emergence Delirium ◽  
Group Assignment ◽  
Repeated Measures Analysis

Background The authors conducted a double-blind, randomized, controlled trial to determine whether the use of sevoflurane in children undergoing anesthesia and surgery results in a higher incidence of postoperative maladaptive behavioral changes as compared with halothane. Methods Children and their parents (n = 102) were randomly assigned to either a halothane group (n = 50) or a sevoflurane group (n = 52). The intraoperative anesthetic protocol was strictly controlled, and the postoperative analgesic consumption and pain levels were recorded. The effect of the group assignment on emergence status and maladaptive postoperative behavioral changes was assessed both by validated psychological measures and physiologic instruments (actigraphy) on postoperative days 1-7. Anxiety of the parent and child was also assessed, as was the child's postoperative recovery (Recovery Inventory). Results There were no group differences in preoperative state anxiety, postoperative analgesic requirements, postoperative pain, or the incidence of emergence delirium (P = not significant). Two-way repeated-measures analysis of variance showed no group differences in the incidence of postoperative maladaptive behaviors (F4,72 = 0.60, P = 0.701) or actigraphic variables such as percent sleep, number of night awakenings, and night awakenings that lasted for more than 5 min (P = not significant). Conclusion The authors found no increased incidence of emergence delirium, maladaptive postoperative behavior changes, or sleep disturbances in children undergoing anesthesia with sevoflurane as compared with halothane.

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