Effect of Dexmedetomedine in Subtenon's Block on Emergence Agitation in Pediatric Strabismus Surgery
Condition: Emergence Agitation
MeSH terms: Psychomotor Agitation; Strabismus; Emergence Delirium
Study type: Interventional

Summary: 
      The study is conducted to evaluate the effects of dexmedetomedine in subtenon's block in
      conjunction to general anesthesia under sevoflurane anesthesia on emergence agitation,
      intraoperative hemodynamic stability, postoperative pain, nausea and vomiting in patients
      undergoing strabismus surgery.
    

Detailed description: 
      Emergency agitation is a clinical status of postoperative excitement or emergence delirium
      when the patient is awake but is disorientated. It is described as mental disturbances that
      consist of confusion, hallucinations and delusions which is manifested by restless
      involuntary physical activity and thrashing about the bed. Its incidence has been observed
      especially in pediatric ophthalmology care units due to many factors such as pain, mental
      status, time of operation, age, lack of ability to see outside, and a history of previous
      hyperthermia. Strabismus surgery is one of the most frequently performed pediatric ocular
      operations. However, it can cause unfavorable side effects during intraoperative and
      postoperative periods. Typically, the major problems associated with strabismus surgeries
      include increased risk of the oculocardiac reflex, postoperative pain, nausea and vomiting.
      Subtenon's block is one of the regional anesthetic techniques used in ocular surgery.
      Dexmedetomidine has been used as an adjuvant to local anesthetics for regional anesthesia in
      various clinical fields including the subtenon's block.There is evidence that dexmedetomidine
      decreases the incidence of agitation after sevoflurane anesthesia in children undergoing
      different surgical procedures. Therefore, this study is conducted to evaluate the effect of
      dexmedetomedine in subtenon's block on emergence agitation in pediatric strabismus surgery
      under sevoflurane anesthesia.

      This prospective, randomized, clinical study includes 100 children who are scheduled for
      elective strabismus surgery under general surgery in Mansoura ophthalmology center. Informed
      written consent is obtained from parents of all subjects in the study after ensuring
      confidentiality.The study protocol is explained to parents of all patients in the study who
      are kept fasting prior to surgery. Patients are randomly assigned to two equal groups
      according to computer-generated table of random numbers using the permuted block
      randomization method.The collected data are coded, processed, and analyzed using SPSS
      program. All data are considered statistically significant if P value is ≤ 0.05.
    

Intervention name(s): Laryngeal Mask Airway; Sevoflurane; Subtenon's Block; Local Anesthetic Solution and Dexmedetomedine; Local Anesthetic Solution
Intervention type(s): Device; Drug; Procedure; Drug; Drug
Intervention description(s): Capnography connected to laryngeal mask airway is introduced after adequate jaw relaxation and oral airway tolerance; its size is chosen according to the body weight of the child.; Sevoflurane in air/oxygen mixture of 40% is titrated to achieve adequate depth of anesthesia.; Subtenon's block is performed in the eye undergoing surgery under sterile conditions where a 19-gauge curved blunt metallic cannula (25 mm) is inserted into sub-tenon's space.; The local anesthetic solution is injected with a dose of 0.5% bupivacaine (0.08 ml/kg), in addition to dexmedetomedine (0.5 μg /kg); The local anesthetic solution is injected with a dose of 0.5% bupivacaine (0.08 ml/kg).
Other intervention name(s): Supraglottic Airway Device; Inhalational Anesthesia; Regional Eye Block; Marcaine and Precedex; Marcaine
Intervention MeSH terms: Anesthetics; Sevoflurane; Bupivacaine; Anesthetics, Local; Pharmaceutical Solutions
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Dexmedetomedine; Subtenon's Block