AUTHOR=Zhu Weichao , Sun Jie , He Jianhua , Zhang Wangping , Shi Meng 

TITLE=A Randomized Controlled Study of Caudal Dexmedetomidine for the Prevention of Postoperative Agitation in Children Undergoing Urethroplasty

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.658047

DOI=10.3389/fped.2021.658047

ISSN=2296-2360

ABSTRACT=Background: Postoperative agitation is a common complication in children undergoing general anesthesia. This study aimed to investigate the effect of caudal dexmedetomidine for the prevention of postoperative agitation in children undergoing urethroplasty.
Materials and Methods: Eighty children were prospectively recruited to this study and randomized to two groups (40 cases in each group), specifically, a dexmedetomidine group (group D) who received 0.2% ropivacaine + 0.5 µg/kg dexmedetomidine for caudal block, and a control group received 0.2% ropivacaine alone. The time to wake up, the time to discharge from the post-anesthesia care unit (PACU), the duration of the caudal block and the Ramsay sedation scale (RSS) were evaluated in the patients. Adverse events such as postoperative agitation, respiratory depression, bradycardia, hypotension, excessive sedation, nausea and vomiting were also recorded during the first postoperative 24 h.
Results: The incidence of postoperative agitation was lower in group D compared to patients in the control group (2.5% vs 22.5%, P=0.007). The time to wake-up and the time to discharge from PACU were longer in group D than in the control group (15.2±2.6 vs13.4±1.3 min, 48.2±7.7 vs 41.5±8.0 min, respectively, P<0.001). However, the extubation times were similar between the 2 groups. The duration of the caudal block was longer in group D compared to the control group (8.8±1.6 vs 4.6±0.7h, P<0.001). 
Conclusions: Caudal dexmedetomidine prolongs the duration of caudal block and decreases the incidence of postoperative agitation in children undergoing urethroplasty.