Dexmedetomidine decreases stress post-operative in pediatrics

Introduction Tracheal extubation causes hypertension and tachycardia. These associated hemodynamic changes are due to sympathetic discharge due to epipharyngeal and laryngeal stimulation.((1)) Aim of work Dexmedetomidine is an effective sedative and analgesic agent, it helps in opioid sparing and multimodal techniques in pediatric anesthesia and reduces the toxicity of common anesthetics, and it has been approved by the end of 1999 by the FDA for human use for sedation in the intensive care unit (ICU). Dexmedetomidine is notable for its ability to provide sedation without risk of respiratory depression and can provide cooperative or arousable sedation. The aim of this study is to assess the effect of administering dexmedetomidine near the end of surgery versus a control group regarding the change in circulatory reflexes (represented by MAP) and the incidence of adverse events such as cough, laryngeal spasm or desaturation. Study design This study was designed as a prospective randomized controlled study. It was conducted in the Pediatrics orthopedic surgery theatre (Abo El Reesh pediatric Hospital) belonging to Cairo university hospitals on 70 patients divided into two groups 35 patients each and aged from 3-12 years planned for elective isolated limb anomaly correction. Result Dexmedetomidine injection near the end of the operation decreased the stress induced during extubation with almost no change in HR or MAP and less cough score, which indicated smoother extubation. Conclusion Dexmedetomidine is a potent alpha 2 receptor agonist, having analgesic and sedative effects and sparing usage of opioids without compromising respiratory reflexes or attenuating cardiovascular response during extubation.