This group will receive 1mcg/kg bolus of dexmedetomidine over 15 minutes after intubation followed by an infusion of dexmedetomidine at 0.5mcg/kg/hr until approximately 30 minutes before the end of surgery.

This group will receive a colorless, odorless liquid (i.e. normal saline) in order to resemble Dexmedetomidine.

Obstructive Sleep Apnea

Dexmedetomidine is an alpha-2 agonist that provides both sedation and analgesia

Dexmedetomidine

Placebo

Montefiore Medical Center

Dex as Analgesic Adjuvant in OSA Patients

A Double Blinded Randomized Placebo Controlled Study Evaluating the Use of Intraoperative Dexmedetomidine in Reducing Postoperative Pain and Narcotic Requirement in Patients With Moderate to Severe OSA.

Patient self-reported pain scores will be measured immediately after awakening post-op using the Numerical Pain Rating Scale and opioid requirements using morphine equivalents

Pain score and opioid requirements will continue to be measured up to 24 hours postoperatively

participants experience of nausea will be reported

Number of hypoxic events will be calculated

Number of days spent in the hospital from admission to discharge will be assessed.

length of time from operation to removal of endotracheal tube will be measured

participants' experiencing vomiting will be assessed and reported by care providers

Acetaminophen PR (20-40mg/kg) after induction of Anesthesia (acetaminophen is in suppository form and given rectally)

Acetaminophen PO (10mg/kg) 60-120min before start of BMT placement (acetaminophen is in syrup form and given by mouth)

Acetaminophen PO (20mg/kg) 60-120min before start of BMT placement (acetaminophen is in syrup form and given by mouth)

Acetaminophen PR (20-40mg/kg) after induction of Anesthesia (acetaminophen is in suppository form and given rectally)
Acetaminophen

Acetaminophen PR

Acetaminophen PO (10mg/kg) 60-120min before start of BMT placement (acetaminophen is in syrup form and given by mouth)
Acetaminophen

Acetaminophen PO-low Dose

Acetaminophen PO (20mg/kg) 60-120min before start of BMT placement (acetaminophen is in syrup form and given by mouth)
Acetaminophen

Acetaminophen PO-high Dose

Total

Sex: Female, Male

Region of Enrollment

EA was evaluated using the Pediatric Anesthesia Emergence Delirium (PAED) scale. This scale measures if the: 1. Child makes eye contact with the caregiver, 2. Child's actions are purposeful, 3. Child is aware of his/her surroundings, 4. Child is restless, 5. Child is inconsolable.
Items 1, 2, and 3 are reversed scored as follows: 4 _ not at all, 3 _ just a little, 2 _ quite a bit, 1 _ very much, 0 _ extremely. Items 4 and 5 are scored as follows: 0 _ not at all, 1 _ just a little, 2 _ quite a bit, 3 _ very much, 4_extremely. Scores of each item are summed to obtain a total PAED scale score, range 0-20, with higher PAED scores indicating a greater degree of emergence delirium.
The average PAED score of all the time points is use

Acetaminophen by Rectum (PR)

Acetaminophen by Mouth (PO) - Low Dose

Acetaminophen by Mouth (PO) - High Dose

Postanesthesia Emergence Agitation (EA) Score

Children's Hospital of Eastern Ontario pain scale (CHEOPS) is an observational scale for measuring postoperative pain in young children. The scale includes six categories of pain behavior: (Cry, facial, verbal, torso, touch, and legs). A score ranging from 0 to 2 or 1 to 3 is assigned to each activity and the summed score ranges between 4 and 13, with a higher score meaning more pain.

Acetaminophen PO - Low Dose

Acetaminophen PO - High Dose

Postanesthesia Pain Score

Overall Study

Dr. Wendy Ren

Emergence Agitation

Pain

Acetaminophen

University of California, Los Angeles Medical Center

Can Acetaminophen Given 1-2 Hours to Children Before Ear Tube Surgery Reduce Agitation After Anesthesia?

Can Acetaminophen PO Given 1-2 Hours Before Bilateral Myringotomy Tube (BMT) Placement Reduce Emergence Agitation (EA) in Children After General Sevoflurane Anesthesia?

Wendy Ren

Physician, Assistant Clinical Professor-Pediatric Anesthesiology

University of California, Los Angeles

0.2 mg/kg methadone by actual body weight, administered over ten minutes, initiated after induction of anesthesia and endotracheal intubation complete.

0.2 mg/kg morphine by actual body weight, administered over ten minutes, initiated after induction of anesthesia and endotracheal intubation complete.

0.2 mg/kg methadone by actual body weight, administered over ten minutes, initiated after induction of anesthesia and endotracheal intubation complete.
Methadone: 0.2 mg*kg-1 by actual body weight, administered over 10 minutes, once induction of anesthesia and endotracheal intubation are complete.

Methadone 0.2 mg/kg

0.2 mg/kg morphine by actual body weight, administered over ten minutes, initiated after induction of anesthesia and endotracheal intubation complete.
Morphine: 0.2 mg*kg-1 by actual body weight, administered over 10 minutes, once induction of anesthesia and endotracheal intubation are complete.

Morphine 0.2 mg/kg

Ethnicity (NIH/OMB)

Number of morphine equivalents used by subject during first 24 hours after discharge from Post-Anesthesia Care Unit

Opioid Consumption

Neil Bailard

Pain, Postoperative

0.2 mg*kg-1 by actual body weight, administered over 10 minutes, once induction of anesthesia and endotracheal intubation are complete.

Methadone

Morphine

Ben Taub General Hospital

Intraoperative Methadone vs Morphine for Postoperative Pain Control in Patients Undergoing Surgery of the Tibia

Intraoperative Methadone Versus Morphine for Postoperative Pain Control in Patients Undergoing Intramedullary Nailing or Open Reduction and Internal Fixation of the Tibia

Neil S Bailard

Assistant Professor, Department of Anesthesiology

Baylor College of Medicine

All enrolled subjects receive the same procedures; bronchoscopy with administration of mechanical and chemical irritants to the airway mucosa

All enrolled subjects underwent bronchoscopy to determine presence of cough as well as the location of airway eliciting a cough response

Lung Transplant Recipients With Stable Lung Function

The number of coughs elicited by placement of biopsy forceps or instillation of dextrose solution on the airway mucosa. The presence of the cough reflex will be assessed with administration of mechanical (biopsy foreceps) and chemical (D5W) at the level of the main carina, proximal to airway anastomosis (native airway) and distal to the airway anastomosis (allograft airway).

Number of Coughs

Presence of cough as elicited by placement of biopsy forceps or instillation of dextrose solution on the airway mucosa. The presence of the cough reflex will be assessed with administration of mechanical (biopsy foreceps) and chemical (dextrose solution) at the level of the main carina, native lung airway and proximal and distal to the airway anastomosis. Lung transplant recipients underwent airway evaluations using the above protocel at 1.5 and 12 months after lung transplantation.
after undergoing transplantation

All enrolled subjects underwent bronchoscopy to determine presence of cough as well as the location of airway eliciting a cough response. Subjects underwent bronchoscopy to elicit cough 1.5 months and 12 months after lung transplantation.

to Assess the Presence and Strength of the Cough Reflex in the Lower Airway for up to One Year

Alexander Duarte, MD

Enrolled subjects underwent bronchoscopy to assess for presence of cough reflex in the transpalnted and non-transplanted lung

codeine/hypoxia

Dex as Analgesic Adjuvant in OSA Patients

Can Acetaminophen Given 1-2 Hours to Children Before Ear Tube Surgery Reduce Agitation After Anesthesia?

Intraoperative Methadone vs Morphine for Postoperative Pain Control in Patients Undergoing Surgery of the Tibia

Assessment of Cough Reflex in Lung Transplant Recipients

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