Dexmedetomidine Versus Magnesium Infusion in Reducing Agitations in Pediatric Patients Undergoing Adenotonsillectomy

NCT ID: NCT05164627

Last Updated: 2021-12-21

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-08

Study Completion Date

2022-12-07

Brief Summary

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The aim of this study is evaluating the efficacy and safety of dexmedetomidine versus Magnesium for reducing emergence agitation after adenotonsillectomy in children.

Secondary outcome is to reduce child needs for analgesics and to reduce their dose.

Detailed Description

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Preoperatively, Intravenous access using EMLA cream will be established in the ward. Child will be introduced to information about GA, OR and surgery. This information will include pictures of the staff and the OR, facemask, blood pressure cuff, etc. The child will move from ward to Pre-Anesthesia Care Unit accompanying his/her parents and anesthesia doctor to establish bonding. Cooperation on induction will be evaluated by using four-point scale with score of 1 to 2 being satisfactory and 3 to 4 being unsatisfactory. If the child develop agitation (Score 3 or 4) emergency Midazolam 0.1 mg/kg IV will be given and the child will be ruled out of study.

Monitors for non-invasive blood pressure, heart rate, electrocardiogram (ECG), pulse oximetry (SpO2) will be attached. Induction of anesthesia will be done using 8% Sevoflurane in oxygen gas with Atracurium 0.5 mg/kg and fentanyl 0.5 mcg/kg to facilitate tracheal intubation. The patients will be divided into three groups:

oGroup A (Dexmedetomidine Group): patients will receive Dexmedetomidine infusion (0.2 mcg/kg/hr) from the start of the surgery till the end of it.

oGroup B (Magnesium Group): patients will receive Magnesium infusion (10 mg/kg/hr) from the start of the surgery till the end of it.

oGroup C (Control Group): Patients will receive Normal Saline 0.9% infusion

Maintenance of anesthesia will be done by using of Sevoflurane 2% in oxygen gas. Controlled mechanical ventilation will be done to maintain normocapnia. Rescue doses of Fentanyl (0.5 mcg/kg) will be given if the patient develop pain. Intraoperative pain is defined as development of Tachycardia (\> 20% of baseline heart rate reading) and Hypertension (\>20% of Baseline Mean Arterial Blood Pressure reading) .

Conditions

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Postoperative Agitations in Pediatric Patients

Keywords

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Dexmedetomidine, Magnesium Sulphate, Agitations

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Group A

patients will receive Dexmedetomidine infusion (0.2 mcg/kg/hr) from the start of the surgery till the end of it.

Group Type ACTIVE_COMPARATOR

Dexmedetomidine

Intervention Type DRUG

patients will receive Dexmedetomidine infusion (0.2 mcg/kg/hr) from the start of the surgery till the end of it.

Group B

patients will receive Magnesium infusion (10 mg/kg/hr) from the start of the surgery till the end of it.

Group Type ACTIVE_COMPARATOR

Magnesium Sulphate

Intervention Type DRUG

patients will receive Magnesium infusion (10 mg/kg/hr) from the start of the surgery till the end of it.

Group C

Patients will receive Normal Saline 0.9% infusion

Group Type PLACEBO_COMPARATOR

Normal saline

Intervention Type DRUG

After patient arrival at the PACU, Paediatric Anaesthesia Emergence Delirium (PAED) scale ,Ramsay sedation scores (RSS), emergence agitation, HR, and mean arterial blood pressure (MAP) were recorded every 5 min during the first 30 min, then every 10 min for the remaining 30 min of the recovery room stay. Patients were then transferred to the ward. All postoperative observations and scores were performed by the same anesthesiologist who was blinded to the group assignment

Interventions

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Dexmedetomidine

patients will receive Dexmedetomidine infusion (0.2 mcg/kg/hr) from the start of the surgery till the end of it.

Intervention Type DRUG

Magnesium Sulphate

patients will receive Magnesium infusion (10 mg/kg/hr) from the start of the surgery till the end of it.

Intervention Type DRUG

Normal saline

After patient arrival at the PACU, Paediatric Anaesthesia Emergence Delirium (PAED) scale ,Ramsay sedation scores (RSS), emergence agitation, HR, and mean arterial blood pressure (MAP) were recorded every 5 min during the first 30 min, then every 10 min for the remaining 30 min of the recovery room stay. Patients were then transferred to the ward. All postoperative observations and scores were performed by the same anesthesiologist who was blinded to the group assignment

Intervention Type DRUG

Other Intervention Names

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patients will receive Magnesium infusion (10 mg/kg/hr) from the start of the surgery till the end of it.

Eligibility Criteria

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Inclusion Criteria

* ASA I or II.
* Age group: 4-12 years old.
* The procedure expected to be completed within 1 hour.

Exclusion Criteria

* Patients with expected difficult airway management.
* lack of consent.
* known adverse effects to dexmedetomidine.
* Mental retardation developmental delay, or neurological or psychiatric illness that may associate with agitation (cerebral palsy, seizure..etc.)
* Hemodynamically unstable patients.
* Persistent cough or high airway secretions.
* Clinical signs of active infectious disease.
* Coagulopathy (INR \>1.5).
* Obesity (BMI \>30 Kg/m2 ).
* Surgical complication
Minimum Eligible Age

4 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

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beshoy gamal

principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ain Shams University

Cairo, , Egypt

Site Status

Countries

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Egypt

References

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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)

Other Identifiers

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Ain Shams University hospital

Identifier Type: -

Identifier Source: org_study_id