Prevention of sevoflurane agitation in children undergoing congenital hernia repair, impact of adding dexmedetomidine to caudal analgesia

Background
Postoperative agitation is a common problem in pediatric sevoflurane-based anesthesia. Dexmedetomidine has been described as a safe, long acting and effective additive in many anesthetic and analgesic techniques. The aim of present study was to evaluate the effect of adding dexmedetomidine to caudal lidocaine in sevoflurane-based anesthesia on the incidence and severity of emergency agitation (EA) in children after surgical repair of congenital hernia.
Patients and methods
A total of 48 pediatric patients aged 18–38 months ASA I, II scheduled for congenital hernia surgery were randomly enrolled into 2 groups: Group L patients ( = 24) received 1% lidocaine 0.7 ml kg, while Group D patients ( = 24) received 1% lidocaine 0.7 ml kg + dexmedetomidine 2 μg/kg. Postoperatively, emergency agitation and modified Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS) scores were observed and recorded.
Results
The current study showed that the incidence and severity of agitation and modified CHEOPS scores were significantly lower in group D compared to group L. Also occurrence of EA in patients in group D was significantly lower.
Conclusion
The present study suggested that use of dexmedetomidine in addition to lidocaine was effective to control emergency agitation after sevoflurane anesthesia.