Abstract

ALVAREZ-BETANCOURT, Ana Elsa; SANCHEZ-HERNANDEZ, Eloy; LOPEZ-GONZALEZ, Brenda Guadalupe  and  RODRIGUEZ-MORENO, Óscar Armando. Subcutaneous dexmedetomidine. Is it useful in the perioperative of the pediatric patient?. Rev. mex. anestesiol. [online]. 2020, vol.43, n.1, pp.16-22.  Epub Sep 27, 2021. ISSN 0484-7903.  https://doi.org/10.35366/cma201c.

Introduction: Dexmedetomidine is an alpha 2 agonist, several clinical effects has been attributed (antinociceptive, hypnotic-sedative, anesthetic, cardiovascular, ventilatory, renal, endocrine and ocular), varied mechanisms of action, and versatility in its administration pathways. It has been used as adjuvant during the perioperative period providing sedation, anxiolysis, delirium prevention and analgesia. In this study we evaluated exclusively subcutaneous administration as an adjuvant, its implications on pain and postoperative comfort (PO). Material and methods: A prospective, observational, descriptive series of cases was performed. Patients 3-15 years of age, scheduled for low abdominal surgery, both genders, ASA I, II. They were divided into four groups: Group I. placebo, group II, III and IV received dexmedetomidine hydrochloride 1, 1.5 and 2 μg/kg respectively. The placebo or dexmedetomidine hydrochloride was administered subcutaneously in the deltoid region. The sedation, delirium and comfort scale were titrated in the immediate postoperative PO to assess the impact of the dose of dexmedetomidine during the emersion. Subsequently, three evaluations of the hemodynamic parameters (TA, FC, SpO2) were performed, as well as the intensity of the pain, the first one at the end of the surgical procedure, 12 and at 24 hours later. Conclusions: Subcutaneous administration of dexmedetomidine in the pediatric patient is a safe and effective alternative, preserving respiratory function, with adequate sedation, hemodynamic stability, improving analgesia (up to 24 hours) after the surgical event, less agitation and delirium in the postoperative resulting in greater comfort.

Keywords : Dexmedetomidine; analgesia; subcutaneous; sedation; pain; pediatrics.

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