Background: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of\nsevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation\nprocess and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with\neither high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of\nsingle dose of intravenous dexmedetomidine.\nMethods: Seventy-five patients (ASA I or II, aged 3ââ?¬â??7 years) undergoing tonsillectomy were randomized into three\nequal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 Ã?¼g/kg (Group D1), or dexmedetomidine\n2 Ã?¼g/kg (Group D2) approximately 10 min before anesthesia. Before the end of surgery, sevoflurane were adjusted to 1.\n5 times, 1.0 time and 0.8 times the minimal effective concentration in groups D0, D1 and D2, respectively. The\nsevoflurane concentration for each group was maintained for at least 10 min before the tracheal deep-extubation was\nperformed. The extubation event, recovery characteristics and post-op respiratory complications were recorded.\nResults: All tracheal tubes in three groups were removed successfully during deep anesthesia. Nine patients in Group\nD0, three patients in Group D1, and two patients in Group D2 required oral airway to maintain a patent airway after\nextubation. The frequency of oral airway usage in groups D1 and D2 were significantly lower than that in Group D0. The\npercentages of patients with ED and the requirements of fentanyl in groups D1 and D2 were also significantly lower\nthan those in Group D0. The time from extubation to spontaneous eye opening in Group D2 was longer than that in\ngroups D0 and D1. The times of post-anesthesia care unit discharge in groups D0 and D2 were longer than that in\nGroup D1. No other respiratory complications and vomiting were observed.\nConclusion: A single dose of intravenous dexmedetomidine as pre-medication in combination with low-concentration\nsevoflurane at the end of surgery provided safe and smooth deep extubation condition and it also lowered the\nemergence agitation in sevoflurane-anaesthetized children undergoing tonsillectomy. Preoperative dexmedetomidine\nat 1 Ã?¼g/kg did not prolong postoperative recovery time.
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