Effect of dexmedetomidine on intracranial pressure in pediatric patients undergoing laparoscopic surgery: ultrasonographic measurement of optic nerve sheath diameter / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the effect of dexmedetomidine on intracranial pressure in pediatric patients undergoing laparoscopic surgery through measurement of optic nerve sheath diameter (ONSD) by ultrasound.Methods:Ninety-three pediatric patients of both sexes, aged 3-12 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with body mass index of 15.2-18.1 kg/m 2, scheduled for elective laparoscopic appendectomy, were divided into 2 groups using a random number table method: control group (group C, n=45) and dexmedetomidine group (group D, n=48). Dexmedetomidine was infused intravenously in a loading dose of 0.5 μg/kg over 10 min before induction of anesthesia followed by an infusion of 0.5 μg·kg -1·h -1 in group D, while the equal volume of normal saline was given instead in group C. ONSD was measured using ultrasound after entering the operating room (T 0), after tracheal intubation (T 1), at 5 min after pneumoperitoneum (T 2), at 5 min after trendelenburg position (T 3), at the end of anesthesia (T 4) and when orientation recovered (T 5). The development of increased intracranial pressure in pediatric patients was diagnosed according to ONSD.The time for extubation, time for recovery of orientation, the Ramsay score when orientation recovered and postoperative nausea and vomiting were recorded. Results:Compared with group C, ONSD was significantly decreased at T 2, 3, the incidence of increased intracranial pressure was decreased, and the Ramsay score when the patients recovered orientation was increased ( P<0.01), and no significant change was found in the time for extubation, time for recovery of orientation and postoperative nausea and vomiting in group D ( P>0.05). Conclusion:Dexmedetomidine can decrease the development of increased intracranial pressure and produces no effect on the postoperative recovery in pediatric patients undergoing laparoscopic surgery.