Study Using Dexmedetomidine to Decreases Emergence Delirium in Pediatric Patients

NCT ID: NCT00778063

Last Updated: 2023-04-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-09-30

Study Completion Date

2013-03-31

Brief Summary

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The purpose of this study is to evaluate the use of intranasal dexmedetomidine to reduce the incidence of emergence delirium during general sevoflurane anesthesia in a pediatric population receiving pressure equalization tubes in one or more ear.

Detailed Description

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Emergence delirium has been described as a dissociated state of consciousness in which the child is irritable, uncompromising, uncooperative, incoherent, inconsolably crying, moaning, kicking or thrashing. The children can run the gambit from restlessness and incoherence to combative and psychotic. The incidence of emergence agitation or delirium is 80% after a procedure with sevoflurane-induced anesthesia.

Dexmedetomidine has been shown to have sedative and analgesic effects. In the pediatric population, it has been shown to provide sedation for radiographic procedures. Intravenously, it is has been shown to decrease emergence delirium following sevoflurane based anesthesia. The ability to administer a medication intranasally might solve the problem of emergence delirium and emergence agitation posed by the young patients undergoing myringotomy and tube placement.

Conditions

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Otitis Media

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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saline

intranasal saline will be given 30 minutes prior to surgery

Group Type PLACEBO_COMPARATOR

saline

Intervention Type DRUG

a volume of intranasal saline, calculated based on body weight, will be given 30 minutes prior to surgery

dexmedetomidine

2 mcg/kg dexmedetomidine will be given intranasally 30 minutes prior to surgery

Group Type EXPERIMENTAL

dexmedetomidine

Intervention Type DRUG

2 mcg/kg intranasally 30 minutes prior to surgery

Interventions

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dexmedetomidine

2 mcg/kg intranasally 30 minutes prior to surgery

Intervention Type DRUG

saline

a volume of intranasal saline, calculated based on body weight, will be given 30 minutes prior to surgery

Intervention Type DRUG

Other Intervention Names

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Precedex

Eligibility Criteria

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Inclusion Criteria

* ASA class 1 or 2 (healthy patient or acute illness)
* Parental willingness to participate
* Candidate for pressure-equalization tubes (PET) as determined by the ENT department

Exclusion Criteria

* ASA class 3 or 4 (chronic illness or life-threatening illness)
* Parental refusal to participate
* Significant liver disease by history
* Allergy to dexmedetomidine or midazolam
* Nasal deformity
* Fever in the three days prior to surgery
* Nausea or vomiting
* History of hypertension
* History of cardiac dysfunction/disorder
* Diabetes mellitus
Minimum Eligible Age

1 Year

Maximum Eligible Age

5 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Ochsner Health System

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Usha Ramadhyani, MD

Role: PRINCIPAL_INVESTIGATOR

Ochsner Health System

Dominic S Carollo, MD

Role: STUDY_DIRECTOR

Ochsner Health System

Locations

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Ochsner Clinic Foundation

New Orleans, Louisiana, United States

Site Status

Countries

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United States

References

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Olympio MA. Postanesthetic delirium: historical perspectives. J Clin Anesth. 1991 Jan-Feb;3(1):60-3. doi: 10.1016/0952-8180(91)90209-6.

Reference Type BACKGROUND
PMID: 2007046 (View on PubMed)

Vlajkovic GP, Sindjelic RP. Emergence delirium in children: many questions, few answers. Anesth Analg. 2007 Jan;104(1):84-91. doi: 10.1213/01.ane.0000250914.91881.a8.

Reference Type RESULT
PMID: 17179249 (View on PubMed)

Cravero J, Surgenor S, Whalen K. Emergence agitation in paediatric patients after sevoflurane anaesthesia and no surgery: a comparison with halothane. Paediatr Anaesth. 2000;10(4):419-24. doi: 10.1046/j.1460-9592.2000.00560.x.

Reference Type RESULT
PMID: 10886700 (View on PubMed)

Mason KP, Zgleszewski SE, Dearden JL, Dumont RS, Pirich MA, Stark CD, D'Angelo P, Macpherson S, Fontaine PJ, Connor L, Zurakowski D. Dexmedetomidine for pediatric sedation for computed tomography imaging studies. Anesth Analg. 2006 Jul;103(1):57-62, table of contents. doi: 10.1213/01.ane.0000216293.16613.15.

Reference Type RESULT
PMID: 16790626 (View on PubMed)

Shukry M, Clyde MC, Kalarickal PL, Ramadhyani U. Does dexmedetomidine prevent emergence delirium in children after sevoflurane-based general anesthesia? Paediatr Anaesth. 2005 Dec;15(12):1098-104. doi: 10.1111/j.1460-9592.2005.01660.x.

Reference Type RESULT
PMID: 16324031 (View on PubMed)

Yuen VM, Irwin MG, Hui TW, Yuen MK, Lee LH. A double-blind, crossover assessment of the sedative and analgesic effects of intranasal dexmedetomidine. Anesth Analg. 2007 Aug;105(2):374-80. doi: 10.1213/01.ane.0000269488.06546.7c.

Reference Type RESULT
PMID: 17646493 (View on PubMed)

Yuen VM, Hui TW, Irwin MG, Yuen MK. A comparison of intranasal dexmedetomidine and oral midazolam for premedication in pediatric anesthesia: a double-blinded randomized controlled trial. Anesth Analg. 2008 Jun;106(6):1715-21. doi: 10.1213/ane.0b013e31816c8929.

Reference Type RESULT
PMID: 18499600 (View on PubMed)

Weldon BC, Bell M, Craddock T. The effect of caudal analgesia on emergence agitation in children after sevoflurane versus halothane anesthesia. Anesth Analg. 2004 Feb;98(2):321-326. doi: 10.1213/01.ANE.0000096004.96603.08.

Reference Type RESULT
PMID: 14742362 (View on PubMed)

Alhashemi JA, Daghistani MF. Effects of intraoperative i.v. acetaminophen vs i.m. meperidine on post-tonsillectomy pain in children. Br J Anaesth. 2006 Jun;96(6):790-5. doi: 10.1093/bja/ael084. Epub 2006 Apr 13.

Reference Type RESULT
PMID: 16613928 (View on PubMed)

Weldon BC, Watcha MF, White PF. Oral midazolam in children: effect of time and adjunctive therapy. Anesth Analg. 1992 Jul;75(1):51-5. doi: 10.1213/00000539-199207000-00010.

Reference Type RESULT
PMID: 1616162 (View on PubMed)

Guler G, Akin A, Tosun Z, Ors S, Esmaoglu A, Boyaci A. Single-dose dexmedetomidine reduces agitation and provides smooth extubation after pediatric adenotonsillectomy. Paediatr Anaesth. 2005 Sep;15(9):762-6. doi: 10.1111/j.1460-9592.2004.01541.x.

Reference Type RESULT
PMID: 16101707 (View on PubMed)

Meistelman C, Plaud B, Donati F. Rocuronium (ORG 9426) neuromuscular blockade at the adductor muscles of the larynx and adductor pollicis in humans. Can J Anaesth. 1992 Sep;39(7):665-9. doi: 10.1007/BF03008227.

Reference Type RESULT
PMID: 1394754 (View on PubMed)

Other Identifiers

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2008.135.C

Identifier Type: -

Identifier Source: org_study_id

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