Application effects of dexmedetomidine combined with sevoflurane for anesthesia in short operations in children with burn injury / 解放军医学杂志

ABSTRACT

Objective To evaluate the effectiveness and safety of dexmedetomidine combined with sevoflurane for anesthesia in short operations in pediatric burn patients. Methods Forty hospitalized children undergoing short operation for burn injury were allocated to sevoflurane group (S group) or sevoflurane combined dexmedetomidine group (group D)(20 patients each). Children in group D inhaled 8% sevoflurane in the beginning until loss of eyelash reflex, and then the density of sevoflurane was reduced to 3% for maintenance, 5µg/(kg.h) of dexmedetomidine was pumped for 10 mins, then the density was reduced to 0.5µg/(kg.h). Then operation was started herewith till to the end. Children in group S received sevoflurane anethesia alone, and dexmedetomidine was replaced by the same volume of physiological saline. Additional 3mg/kg propofol was injected when anesthesia was inadequate. During the procedure, HR, MAP, SpO2 and Ramsay scale were recorded at baseline (T1), loss of eyelash reflex (T2), 5min after the start of operation (T4), 10min (T5) and the end of operation (T6). The operation time, anethesia time, propofol consumption, case of respiratory depression and pediatric anesthesia emergence delirium scale (PAED) in pediatric anesthesia care unit (PACU) were recorded. Results There was no significant difference in operation time between the two groups. Intraoperative SpO2 was higher in group D than in group S (P<0.05), respiratory inhibition occurred in 4 cases of group D and 10 cases of group S (P<0.05). Propofol consumption was less and the operation time was longer in group D than in group S (P<0.05). At T3-T6, the MAP and HR were lower, but the Ramsay scale was higher in group D than in group S (P<0.05). In PACU, PAED scale was lower in group D than in group S (P<0.05). Conclusions Dexmedetomidine combined with sevoflurane for anesthesia for short burn surgery in children not only stabilize hemodynamic parameters but also reduce the impact to respiration. Although delaying the recovery time, this combination may improve the recovery quality.