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High-dose dexmedetomidine increases the opioid-free interval and decreases opioid requirement after tonsillectomy in children

Purpose Dexmedetomidine, a selective α 2 adrenoreceptor agonist, has analgesic and sedative properties, minimal impact on respiratory parameters, and reportedly decreases analgesic requirements after surgery. Given its pharmacodynamic profile, dexmedetomidine might have a role for postoperative pain...

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Bibliographic Details
Published in:Canadian journal of anesthesia 2011-06, Vol.58 (6), p.540-550
Main Authors: Pestieau, Sophie R., Quezado, Zenaide M. N., Johnson, Yewande J., Anderson, Jennifer L., Cheng, Yao I., McCarter, Robert J., Choi, Sukgi, Finkel, Julia C.
Format: Article
Language:English
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Summary:Purpose Dexmedetomidine, a selective α 2 adrenoreceptor agonist, has analgesic and sedative properties, minimal impact on respiratory parameters, and reportedly decreases analgesic requirements after surgery. Given its pharmacodynamic profile, dexmedetomidine might have a role for postoperative pain control in children undergoing tonsillectomy. In this study, we hypothesized that dexmedetomidine would delay and decrease opioid requirements after tonsillectomy. Methods In a double-blind controlled trial, participants undergoing tonsillectomy were randomized to receive one intravenous dose of fentanyl (1 μg·kg −1 or 2 μg·kg −1 ) or dexmedetomidine (2 μg·kg −1 or 4 μg·kg −1 ) immediately after endotracheal intubation. Primary outcomes included requirement for rescue morphine in the initial postoperative period. Results One hundred and one children were enrolled. During the postoperative period, dexmedetomidine (2 and 4 μg·kg −1 groups combined) significantly prolonged the opioid-free interval of children who underwent tonsillectomy compared with fentanyl (1 and 2 μg·kg −1 groups combined) ( P  
ISSN:0832-610X
1496-8975
DOI:10.1007/s12630-011-9493-7