Effects of different doses of dexmedetomidine on agitation after ketamine anesthesia in children

Objective To investigate the effects of different doses of dexmedetomidine on restlessness after ketamine anesthesia in children undergoing short-term surgery. Methods From January 2017 to June 2017, 90 pediatric patients aged 11-15 years who underwent ketamine anesthesia and minor surgery in the Department of Pediatrics, Xiangya Second Hospital of Central South University were divided into group A, B and C according to the random number table method. Thirty patients in each group were given ketamine intravenously at a dose of 1 mg/kg at the beginning of operation, and then group A received intravenous maintenance anesthesia at a rate of 0.2 μg/(kg·h) of dexmedetomidine. Group B was anesthetized at a rate of 0.4 μg/(kg·h). Group C was anesthetized at a rate of 0.8 μg/(kg·h). The patients had the same operation mode. The recovery time and extubation time of the children were compared. Malviya score was used to evaluate the incidence of restlessness after the operation, Ramasy sedation score was used to evaluate the condition of the children after the operation, and finally vision was used. The analogue scale (VAS) was used to evaluate the pain level of children 1 and 2 hours after operation. Results The shortest wake-up time and extubation time were found in group A, followed by group B, and the longest was in group C, with statistical significance (all P<0.05); the restlessness rate in group A was higher than that in group B and C, and that in group C was higher than that in group B, with statistical significance (all P<0.05); Ramasy sedation score in group A was (1.32±0.21), group B was (3.14±0.51), and group C was (4.22±0.61). Significance (P<0.05), in which group C was higher than group A and B, and group B was higher than group A (all P<0.05); VAS score of group A was the highest at 1 h and 2 h after operation, followed by group B, and VAS score of group C was the lowest, with statistical significance (all P<0.05). Conclusion The use of 0.4 μg/(kg·h) dexmedetomidine in children undergoing minor surgery after anesthesia with low dose ketamine can shorten the recovery time and extubation time, reduce the occurrence rate of restlessness and pain, and reduce the occurrence rate of sequelae such as sleepiness after surgery.