Faculty Advisor(s)

Cheryl Nimmo

Document Type

Capstone

Publication Date

6-2017

Rights

© 2017 Lauren Anderson

Abstract

This review examines the use of intravenous dexmedetomidine in the role of decreasing or preventing emergence delirium in pediatric patients undergoing ambulatory surgery. The included randomized controlled trials evaluated the administration of dexmedetomidine, whether as a bolus, infusion, or in combination, and its effectiveness in preventing or reducing emergence delirium. The analysis scales for emergence delirium varied between studies, and it was noted that multiple scale components overlapped with pain scale components used in the trials. It has also been noted that differentiating between pain and emergence delirium can be challenging for clinicians (Somaini, Engelhardt, Fumagalli & Ingelmo, 2016). To address this challenge, both the prevalence of pain and emergence delirium were assessed. Variations between studies included the administration of premedication, surgical procedure performed, and other pharmacological agents administered during the perioperative period. Eleven of the twelve trials demonstrated that dexmedetomidine decreased the incidence of emergence delirium when compared to the use of a placebo and eight studies reported decreased pain scores. Thus, it can be suggested that dexmedetomidine is an adequate pharmacological option to help prevent the incidence of emergence delirium and pain, regardless of whether the two outcomes are tied together. However, it is imperative that further research be performed to establish the most effective time during the perioperative period dexmedetomidine should be administered. In addition, further research must be performed to establish a dose that allows for the prevention of emergence delirium, but not at an expense of the increased discharge time.

Comments

Master's capstone

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