Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery

Bibliographic Data

ID15718320
AuthorsSrijaya K Reddy (0000-0002-1924-8976, Vanderbilt University Medical Center, corresponding author), Jacob Jones (0000-0001-9522-0505, George Washington University), Heather Gordish‐Dressman (0000-0002-2330-5427, George Washington University), Heather Gordish-Dressman (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), Sophie R Pestieau (0000-0001-7667-3955, George Washington University), Sophie Pestieau (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)
Year2020
Volume7
Issue7
Pages68-68
Publication date2020-07-01
Open AccessYes
TypeARTICLE
VenueChildren (JOURNAL)
Journal identifiersISSN: 2227-9067 • E-ISSN: 2227-9067
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/children7070068
PMID32630167
OpenAlexW3039658087
LanguageEN
Citations received1
References cited18

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

Analgesic · Anesthesia · Craniofacial · Craniofacial surgery · Dexmedetomidine · Morphine · Nausea · Opioid · Perioperative · Postoperative nausea and vomiting · Reconstructive surgery · Sedation · Vomiting · Anesthesia and Pain Management · Anesthesia and Sedative Agents · Medicine · Nausea and vomiting management · Internal Medicine · Surgery

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