ABSTRACT
Because of the high incidence and untoward effects of emergence delirium in the pediatric population, investigating pharmacologic measures for preventing this phenomenon is important to the anesthesia provider. Dexmedetomidine, a highly selective α2 agonist, has been shown to prevent emergence delirium in the perioperative setting; however, recommendations for best practice regarding use of this medication are not widely available. Barriers to the use of dexmedetomidine may include side effects such as bradycardia and delayed emergence, as well as limited evidence for the best practice of timing, method, and dosing of dexmedetomidine. This review of the evidence included 2,142 study participants ranging in age from 1 to 15 years. The findings suggest that administering an intravenous bolus dose of 0.5 µg/kg of body weight in the intraoperative phase demonstrated a significant reduction in the incidence of emergence delirium with minimal side effects. Administration of dexmedetomidine immediately following induction of anesthesia revealed benefit in these patients without a delay in emergence from anesthesia. Along with the benefit of preventing emergence delirium in pediatric patients, the evidence also suggests that dexmedetomidine may lower volatile-agent and analgesic requirements.
Subject(s)
Dexmedetomidine/administration & dosage , Emergence Delirium/prevention & control , Hypnotics and Sedatives/administration & dosage , Adolescent , Child , Child, Preschool , Drug Administration Schedule , Humans , Infant , Nurse AnesthetistsABSTRACT
There is much research about the negative effect of serious and chronic childhood illness on the parent's partner relationship. It is generally assumed that parents of newborns admitted to the neonatal intensive care unit (NICU) also share this risk of relationship strain. However, little research specific to the effects of the NICU on the parent's relationship exists. The focus of most research examining parents of NICU infants is the mother's emotional well-being. The effect on the father is rarely studied. Drawing from studies of other childhood illnesses, it is reasonable to hypothesize that the experience of a NICU hospitalization may also strain the parents' relationship, possibly to the point of dissolution. The implementation of family-centered care in the NICU has had promising outcomes, and it is hypothesized that family-centered care will minimize the emotional stressors that may lead to the dissolution of the parent's partner relationship.
