Effect of intranasal dexmedetomidine or intranasal midazolam on prevention of emergence agitation in pediatric strabismus surgery: A randomized controlled study

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

able 1 Demographic data, Preoperative Anxiety Scale, surgery duration, time to eye opening, pain scale, duration of stay in PACU, in control, dexmedetomidine, and midazolam groups.

	Group C N = 32	Group D N = 33	Group M N = 33
ASA Status (I/II)	31/1	32/1	33/0
Age (year)	2.78 ± 1.67	2.68 ± 1.54	2.48 ± 1.17
Weight (kg)	11.4 ± 3.3	12 ± 3.9	11.8 ± 3.7
Gender (male/female)	18/14	17/16	17/16
Surgery duration (min)	42.27 ± 3.507	45.93 ± 3.378	46.27 ± 3.608
Time to eye opening (min)	3.23 ± 1.270	2.14 ± 0 .170	3.23 ± 1.270
Patients requiring rescue analgesia n (%)	6 (18%)	3(9%)	4(12%)
FLACC scale	3 (0–9)	3.5 (0–9)	3 (0–9)
m-YPAS scale	36 (24–61)	34 (25–61)	35 (26–58)
Duration of PACU stay (min)	43.68 ± 2.032	44.39 ± 3.432	45.78 ± 3.032

PACU, Post-anesthesia care unit; FLACC scale, Face, Legs, Activity, Cry and Consolability Scale; m-YPAS, modified Yale Preoperative Anxiety Scale in the preoperative holding area. Values are expressed as mean ± SD or median (range).

able 2 Incidence of emergence agitation (PAED ⩾ 10), severe emergence agitation (PAED ⩾ 15), postoperative vomiting (POV), and intraoperative Oculocardiac reflex in the control, dexmedetomidine, and midazolam groups.

	Group C N = 32	Group D N = 33	Group M N = 33
PAED score ⩾ 10, n (%)	15 (47%)	4 (12%)^⁎^,^†	7 (21%)^⁎
PAED score ⩾ 15, n (%)	8 (25%)	2 (6%)^⁎	3 (9%)^⁎
POV (one episode), n (%)	9 (28%)	5 (15%)^⁎^,^†	7 (21%)
POV (two or more episodes), n (%)	7 (22%)	1 (3%)^⁎^,^†	6 (18%)
Oculocardiac reflex requiring atropine, n (%)	13 (39%)	0 (0%)^⁎	3 (9%)^⁎
Nasal irritation, n (%)	0 (0%)	0 (0%)^†	7 (21%)

PAED = Pediatric Anesthesia Emergence Delirium scale (scale 0–20); POV = postoperative vomiting.

#x204E; P < 0.05 for dexmedetomidine or midazolam group versus control group.

#x2020; P < 0.05 for dexmedetomidine versus midazolam group.

able 3 Pediatric Anesthesia Emergence Delirium (PAED) scale in control, dexmedetomidine, and midazolam groups at different time intervals in PACU.

	Group C N = 32	Group D N = 33	Group M N = 33
Arrival – Median (range)	9 (0–18)	4 (0–16)^⁎^,^†	7 (0–16)^⁎
5 min – Median (range)	9 (0–15)	4 (0–15)^⁎^,^†	6 (0–15)^⁎
15 min – Median (range)	7 (0–15)	4 (0–9)^⁎^,^†	6 (0–10)^⁎
30 min – Median (range)	5 (0–17)	0 (0–5)^⁎^,^†	3 (0–15)^⁎
45 min – Median (range)	2 (0–17)	0 (0–5)	2 (0–15)
60 min – Median (range)	2 (0–17)	0 (0)	0 (0–2)

PAED scale at arrival to PACU, and 5, 15, 30, 45 and 60 min later. Data are expressed as median and range. Between-group analysis using one way ANOVA.

#x204E; P > 0.05 for dexmedetomidine or midazolam group vs. control group.

#x2020; P > 0.05 for dexmedetomidine vs. midazolam group.