Optimizing surgical field during cochlear implant surgery in children: Dexmedetomidine versus Esmolol

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

igure 1 Patient flow diagram.

able 1 FLACC scale.

Criteria	Score 0	Score 1	Score 2
Face	No particular expression or smile	Occasional grimace or frown, withdrawn, uninterested	Frequent to constant quivering chin, clenched jaw
Legs	Normal position or relaxed	Uneasy, restless, tense	Kicking, or legs drawn up
Activity	Lying quietly, normal position, moves easily	Squirming, shifting back and forth, tense	Arched, rigid or jerking
Cry	No cry (awake or asleep)	Moans or whimpers; occasional complaint	Crying steadily, screams or sobs, frequent complaints
Consolability	Content, relaxed	Reassured by occasional touching, hugging or being talked to, distractible	Difficult to console or comfort

The Face, Legs, Activity, Cry, Consolability scale or FLACC scale is a measurement used to assess pain for children between the ages of 2 months–7y or individuals that are unable to communicate their pain. The scale is scored between a range of 0–10 with 0 representing no pain while 10 representing the worst pain. The scale has 5 criteria each assigned a score of 0, 1 or 2.

able 2 Demographic data; duration of surgery, tramadol consumption; time of first analgesic requirement.

Variables	Group (D) N = 35	Group (E) N = 35	P value
Age (yr)	2.3 ± 1.08	2.8 ± 1.24	0.15
Weight (kg)	14.4 ± 1.93	12.10 ± 1.71	0.68
Sex (M/F)	19/16	20/15
Duration of surgery (min)	90.65 ± 6.16	92.75 ± 6.58	0.71
Tramadol consumption (mg)	10.45 ± 10.05	18.25 ± 11.57	0.01
Time to first analgesic request (h)	8.95 ± 2.06	4.85 ± 1.87	0.02

able 3 The value of pain score.

Time (h)	Group D N = 35	Group E N = 35	P1
2	1.05 ± 0.8	1.03 ± 0.85	0.573
4	1.37 ± 1.85	3.17 ± 0.59	0.0.03
6	2.2.±0.80	4.0.13 + 0.68	0.01
8	4.30 ± 0.27	5.90 ± 0.79	0.01
12	5.4000 ± 0.84	5.85 ± 1.075	0.6
18	4.45 ± 0.90	4.30 ± 0.65	0.1

able 4 Quality of surgical field.

Predefined scale	Group D N = 35	Group E N = 35	P
0	0	0
1	20	18	0.7
2	13	15	0.4
3	2	2	0.6
4	0	0
5	0	0

able 5 Changes in MABP.

Time	Group D N = 35	Group E N = 35	P1
T0	65.54 ± 5.33	62.45 ± 4.52	0.62
T1	68.62 ± 4.25	65.54 ± 4.45	0.74
T2	55.52 ± 3.42	54.45 ± 4.33	0.43
T3	48.45 ± 5.40	46.54 ± 34	0.65
T4	52.54 ± 4.33	54.33 ± 4.42	0.56
T5	55.52 ± 4.32	54.34 ± 3,54	0.53

T0 = baseline, t1 = after intubation, t2 = 5 min after drugs infusion, t3 = 30 min after drugs infusion, t4 = 60 min after drugs infusion and t5 = 90 min after drugs infusion.

able 6 Changes in HR.

Time	Group D N = 35	Group E N = 35	P1
T0	127.45 ± 4.82	125.65 ± 5.44	0.64
T1	121.33 ± 5.32	122.48 ± 4,55	0.72
T2	104.32 ± 5.42	106.54 ± 4.23	0.62
T3	89.45 ± 4.32	92.43 ± 4.33	0.73
T4	85.3 ± 5.34	90.53 ± 4,32	0.67
T5	80.24 ± 3.4	85.43 ± 4.34	0.72

T0 = baseline, t1 = after intubation, t2 = 5 min after drugs infusion, t3 = 30 min after drug infusion, t4 = 60 min after drugs infusion and t5 = 90 min after drugs infusion.