Abstract：
Introduction: Postoperative agitation is a common complication of sevoflurane anesthesia in children and might lead to self-harm and recovery disruption. This study aimed to compare the prophylactic effect of dexmedetomidine and remifentanil on postoperative agitation after anesthesia with sevoflurane. Methods: In this clinical trial, 60 children aged 2 to 7 years with ASA class І, II, candidates for elective strabismus surgery, were randomly assigned to three groups using block randomization. Patients in the first group D received 0.5 µgr/kg dexmedetomidine, the second group R received 0.1 µgr/kg remifentanil, and another group C received normal saline at the end of anesthesia. Children\'s agitation degree was measured by the Pediatric Anesthesia Emergence Delirium (PAED) scales and the 4-point agitation scale at the time of extubation, entering the recovery room, 10, 20, and 30 minutes after entrance. Data analysis was performed using descriptive and inferential statistical tests. Results: The postoperative agitation and pain were significantly lower among children who received dexmedetomidine compared with those in remifentanil and the control group (p < .001). It was observed that the administration of dexmedetomidine at the end of anesthesia significantly decreased the incidence of postoperative agitation (p < .001). None of the patients in group D had a PAED score of over 12. Conclusion: Based on PAED and the 4-point scales, none of the cases in group D had experienced postoperative agitation; this made a significant statistical difference compared with groups C and R (p-value <. 001). Although both dexmedetomidine and remifentanil can prevent and attenuate postoperative agitation, dexmedetomidine administration seems significantly more effective.
摘要：
简介：术后躁动是儿童七氟醚麻醉的常见并发症，可能导致自我伤害和恢复中断。本研究旨在比较右美托咪定与瑞芬太尼对七氟醚麻醉后躁动的预防效果。方法：在这项临床试验中，60名2至7岁的儿童参加ASAA级，II,选择性斜视手术的候选人，使用区组随机化随机分配到三组。第一组D患者接受0.5µgr/kg右美托咪定，第二组R接受0.1μgr/kg瑞芬太尼，另一个C组在麻醉结束时接受生理盐水。通过小儿麻醉出现谵妄（PAED）量表和拔管时的4点躁动量表测量儿童的躁动程度，进入恢复室,进入后10、20和30分钟。使用描述性和推断性统计检验进行数据分析。结果：与瑞芬太尼和对照组相比，接受右美托咪定的患儿术后躁动和疼痛明显减少（p<0.001）。观察到在麻醉结束时给予右美托咪定显著降低术后躁动的发生率(p<.001)。D组中没有患者的PAED评分超过12。结论：基于PAED和4分量表，D组无一病例发生术后躁动；与C组和R组相比，差异有统计学意义（p值<。001).尽管右美托咪定和瑞芬太尼都可以预防和减轻术后躁动，右美托咪定给药似乎更有效.
