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Dexmedetomidine sedation with nerve blocks for surgical procedures
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| bet | 155/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
| Dexmedetomidine sedation with nerve blocks for surgical procedures: In a RCT [18] in 104 infants (75% born preterm), with mean post-menstrual age of 41 weeks and mean weight of 3.5 kg at the time of surgery, were allocated to dexmedetomidine sedation with caudal block (n=51) versus general sevoflurane anaesthesia with tracheal intubation and caudal block (n=46) for elective bilateral inguinal hernia surgery. Dexmedetomidine was given at a bolus dose of 2 microgram/kg over the first 10 min, followed by 1 microgram/kg over the next 10 min to achieve a Ramsay score of 3-4. Sedation was maintained with dexmedetomidine infusion at 0.2 microgram/kg/hour to maintain a Ramsay score of 3-4. In the dexmedetomidine group, 46 infants (90.2%) had their operations completed solely under this technique, two (3.9%) were converted to general anaesthesia with intubation, and three (5.9%) required brief administration of nitrous oxide or low-dose sevoflurane. Overall, 96.1% of infants in the dexmedetomidine group did not require intubation.
Conclusion: Dexmedetomidine sedation with loading dose of 2-3 microgram/kg and maintenance dose of 0.2 microgram/kg/hour with caudal block provides a feasible alternative to general anaesthesia in infants undergoing hernia surgery although supplemental methods were required in 9.8%. [18] [LOE II neonates]
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