Laryngeal mask airway is inserted and anesthesia is maintained with sevoflurane. Subtenon's block is performed and local anesthetic solution is injected, in addition to dexmedetomedine.

Laryngeal mask airway is inserted and anesthesia is maintained with sevoflurane. Subtenon's block is performed and local anesthetic solution is injected.

Emergence Agitation

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.

Laryngeal Mask Airway

Sevoflurane in air/oxygen mixture of 40% is titrated to achieve adequate depth of anesthesia.

Sevoflurane

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.

Subtenon's Block

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)

Local Anesthetic Solution and Dexmedetomedine

The local anesthetic solution is injected with a dose of 0.5% bupivacaine (0.08 ml/kg).

Local Anesthetic Solution

Department of Anesthesia, Mansoura University Hospitals

Effect of Dexmedetomedine in Subtenon's Block on Emergence Agitation in Pediatric Strabismus Surgery

Effect of Dexmedetomedine in Subtenon's Block on Emergence Agitation in Pediatric Strabismus Surgery Under Sevoflurane Anesthesia

Agitation is assessed using the 5- step Cravero scale (1-5) every five minutes from awakening and for 30 minutes.(1:Obtunded with no response to stimulation, 2:Asleep but responsive to movement or stimulation, 3:Awake and responsive, 4:Crying, 5:Thrashing behaviour that requires restraint)

Emergence time (min) is recorded; from the discontinuation of sevoflurane to the first response on verbal command.

Heart rate (beat/min) is recorded at five-minute intervals until the end of the surgery.

Blood pressure (mmHg) is recorded at five-minute intervals until the end of the surgery.

If there is dysrhythmia or rapid reduction in HR by more than 25% from the baseline, it is considered as an oculocardiac reflex.

Pain score from 0 to 10 (0 = no pain and 10 = the worst imaginable pain) is assessed every two hours up to 24 hours after the procedure.

The amount of paracetamol consumption given as a rescue analgesia to patients is measured all over the 24 hours.

The time of the first analgesic request for paracetamol is recorded.

Incidence of postoperative nausea and vomiting is assessed up to 24 hours after the procedure.

sfathy

Lecturer of anesthesia, ICU & pain management; Faculty of Medicine

BIS range under 40
BIS: BIS monitoring provides the patient’s depth of consciousness, enables us to monitor safe, optimal anesthesia for each patient.

Low Bispectral Index (BIS) Group

BIS range from 40 to 60
BIS: BIS monitoring provides the patient’s depth of consciousness, enables us to monitor safe, optimal anesthesia for each patient.

Normal BIS Group

Total

Sex: Female, Male

Race and Ethnicity Not Collected

Evaluating the Pediatric Anesthesia Emergence Delirium (PAED) score 3 times at the post-anesthetic care unit (PACU): when participant arrived at PACU, measure the PAED score (from 0 to 20; the higher score indicates the severer emergenct agitation) immediately and if the score is 10 or over 10, give the participant Fentanyl 1mcg/kg. Repeat checking the PAED score 2 times more with 15 minutes interval.

the Pediatric Anesthesia Emergence Delirium (PAED) Score

Bispectral index (BIS) range from 40 to 60
BIS: BIS monitoring provides the patient’s depth of consciousness, enables us to monitor safe, optimal anesthesia for each patient.

Normal Bispectral Index (BIS) Group

Overall Study

Dr. YEA JI LEE

Strabismus

BIS monitoring provides the patient's depth of consciousness, enables us to monitor safe, optimal anesthesia for each patient.

strabismus/feber

Effect of Dexmedetomedine in Subtenon's Block on Emergence Agitation in Pediatric Strabismus Surgery

Anesthetic Depth and the Incidence of Emergence Agitation in Children Undergoing Strabismus Surgery

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