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Brief Report

Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery

1
Department of Anesthesiology, Division of Pediatric Anesthesiology—Monroe Carell Jr. Children’s Hospital, Vanderbilt University Medical Center, 2200 Children’s Way Suite 3116, Nashville, TN 37232, USA
2
Division of Anesthesiology, Pain and Perioperative Medicine—Children’s National Hospital, The George Washington University School of Medicine and Health Sciences, 111 Michigan Avenue NW, Washington, DC 20010, USA
3
Center for Translational Research—Children’s National Hospital, The George Washington University School of Medicine and Health Sciences, 111 Michigan Avenue NW, Washington, DC 20010, USA
*
Author to whom correspondence should be addressed.
Received: 22 May 2020 / Revised: 18 June 2020 / Accepted: 23 June 2020 / Published: 1 July 2020
(This article belongs to the Special Issue Pediatric Anesthesia)
Pediatric craniofacial reconstruction surgery is associated with significant perioperative analgesic requirements. As dexmedetomidine mediates central nervous system sympathetic activity and pain modulation, its intraoperative use could be beneficial in craniofacial surgery. We hypothesized that intraoperative administration of dexmedetomidine in children undergoing craniofacial reconstructive surgery would result in reduced opioid requirements, pain, sedation scores, and opioid-induced side effects compared to patients who did not receive dexmedetomidine. All patients who underwent craniofacial reconstructive surgery at our institution from July 2013 to June 2017 were retrospectively evaluated. The primary outcome measure was mean postoperative morphine equivalent requirements. Secondary outcome measures included incidence of opioid-related side effects, pain scores, and hospital length of stay. Thirty-nine patients received dexmedetomidine intraoperatively while 41 patients did not. There was no difference in postoperative opioid requirements or pain scores between the two cohorts. However, patients who received higher doses of dexmedetomidine (4.7 mcg/kg) intraoperatively exhibited significantly lower rescue medication requirements for nausea and vomiting postoperatively. Contrary to the hypothesis, dexmedetomidine was not associated with reduced postoperative opioid requirements or pain scores in children undergoing craniofacial reconstructive surgery. However, our findings do suggest that dexmedetomidine may be beneficial in reducing side effects such as postoperative nausea and vomiting. A randomized controlled trial would be necessary to verify these findings. View Full-Text
Keywords: craniosynostoses; pediatric; anesthesia; postoperative pain craniosynostoses; pediatric; anesthesia; postoperative pain
MDPI and ACS Style

Reddy, S.K.; Jones, J.J.; Gordish-Dressman, H.; Pestieau, S.R. Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery. Children 2020, 7, 68. https://0-doi-org.brum.beds.ac.uk/10.3390/children7070068

AMA Style

Reddy SK, Jones JJ, Gordish-Dressman H, Pestieau SR. Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery. Children. 2020; 7(7):68. https://0-doi-org.brum.beds.ac.uk/10.3390/children7070068

Chicago/Turabian Style

Reddy, Srijaya K., Jacob J. Jones, Heather Gordish-Dressman, and Sophie R. Pestieau 2020. "Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery" Children 7, no. 7: 68. https://0-doi-org.brum.beds.ac.uk/10.3390/children7070068

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