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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 4, July-August 2019, Pages 1387-1397
 

Original Article

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

Puneeth J1, Mahantesh S Mudakanagoudar2

1Senior Resident, Dept. of Anesthesiology and Critical Care, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka 560004, India. 2Associate Professor, Dept. of Anaesthesiology, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka 580009, India.

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

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.


Keywords : Agitation; Dexmedetomidine; Fentanyl; Sevoflurane.
Corresponding Author : Mahantesh S Mudakanagoudar