Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Outcomes of Interest
2.2. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Intraoperative Practices
3.3. Postoperative Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Did Not Receive Dexmedetomidine | Received Dexmedetomidine | ||||||
---|---|---|---|---|---|---|---|
N (%) | Mean ± SD | Median (Min–Max) | N (%) | Mean ± SD | Median (Min–Max) | p-Value | |
Age (months) | 41 | 32 ± 31 | 26 (5–144) | 39 | 29 ± 31 | 16 (4–132) | 0.78 |
Weight (kg) | 41 | 15 ± 7 | 14.0 (6–36) | 39 | 14 ± 8 | 10 (5–45) | 0.06 |
Sex | 0.03 | ||||||
Female | 12 (29) | 21 (54) | |||||
Male | 29 (71) | 18 (46) | |||||
Race | 0.40 | ||||||
Asian | 2 (5) | 0 (0) | |||||
Black | 11 (27) | 9 (23) | |||||
Other | 5 (12) | 3 (8) | |||||
White | 23 (56) | 27 (69) | |||||
Ethnicity | 0.10 | ||||||
Hispanic | 8 (19) | 14 (36) | |||||
Non-Hispanic | 33 (81) | 25 (64) | |||||
ASA classification | 0.38 | ||||||
1 | 2 (5) | 0 (0) | |||||
2 | 27 (66) | 17 (63) | |||||
3 | 12 (29) | 12 (31) | |||||
Syndromic | 0.81 | ||||||
No | 35 (85) | 34 (87) | |||||
Yes | 6 (15) | 5 (13) | |||||
Sutures | 0.07 | ||||||
1 | 16 (39) | 21 (54) | |||||
2 | 3 (7) | 7 (18) | |||||
3 | 7 (17) | 6 (15) | |||||
≥4 | 15 (37) | 5 (13) | |||||
Operative time (minutes) | 41 | 287 ± 103 | 265 (123, 555) | 39 | 264 ± 84 | 252 (106, 588) | 0.48 |
PICU length of stay (days) | 0.35 | ||||||
2 | 37 (90) | 31 (80) | |||||
3 | 3 (7) | 7 (18) | |||||
4 | 1 (3) | 1 (2) | |||||
Total hospital length of stay (days) | 41 | 4.2 ± 1.0 | 4 (2, 8) | 39 | 4.0 ± 0.8 | 4 (3, 7) | 0.30 |
Mechanical ventilation (days) | 0.33 | ||||||
0 | 40 (98) | 39 (100) | |||||
1 | 1 (2) | 0 (0) |
Did Not Receive Dexmedetomidine | Received Dexmedetomidine | ||||||
---|---|---|---|---|---|---|---|
N (%) | Mean ± SD | Median (Min–Max) | N (%) | Mean ± SD | Median (Min–Max) | p-Value | |
Average postoperative pain score | 41 | 2.7 ± 1.2 | 2.5 (0.7–5.3) | 39 | 2.7 ± 1.3 | 2.6 (0.3–6.3) | 0.99 |
Highest postoperative pain score | 41 | 7.1 ± 0.3 | 7 (4–10) | 39 | 7.2 ± 2.1 | 7 (2–10) | 0.90 |
Postoperative morphine equivalent administration (mg/kg) | 41 | 0.4 ± 0.3 | 0.31 (0–1.2) | 39 | 0.3 ± 0.2 | 0.3 (0–0.8) | 0.70 |
Postoperative acetaminophen administration (mg/kg) | 41 | 58 ± 19 | 61 (0–87) | 39 | 56 ± 17 | 60 (15–90) | 0.24 |
Postoperative ketorolac administered | 0.78 | ||||||
No | 36 (88) | 35 (90) | |||||
Yes | 5 (12) | 4 (10) |
Cohort | Rescue Medication | N | Coefficient | 95% CI | p-Value |
---|---|---|---|---|---|
Including all patients (those who did not receive dexmedetomidine have a value of zero) | ondansetron | 80 | −0.342 † | −0.682–0.002 | 0.049 |
promethazine | 80 | −1.467 | −5.345–2.411 | 0.46 | |
benzodiazepine | 80 | 0.198 | −0.514–0.910 | 0.59 | |
diphenhydramine | 80 | −79.408 | −44605–44445 | 0.99 | |
naloxone | 80 | −79.302 | −89130–88971 | 0.99 | |
Including only patients who received dexmedetomidine | ondansetron | 39 | −0.789 † | −1.438–0.140 | 0.017 |
promethazine | 39 | −8.067 | −22.139–6.005 | 0.26 | |
benzodiazepine | 39 | −0.060 | −1.177–1.057 | 0.92 | |
diphenhydramine | 39 | N/A * | |||
naloxone | 39 | N/A * |
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Reddy, S.K.; Jones, J.J.; Gordish-Dressman, H.; Pestieau, S.R. Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery. Children 2020, 7, 68. https://doi.org/10.3390/children7070068
Reddy SK, Jones JJ, Gordish-Dressman H, Pestieau SR. Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery. Children. 2020; 7(7):68. https://doi.org/10.3390/children7070068
Chicago/Turabian StyleReddy, Srijaya K., Jacob J. Jones, Heather Gordish-Dressman, and Sophie R. Pestieau. 2020. "Dexmedetomidine as an Opioid-Sparing Agent in Pediatric Craniofacial Surgery" Children 7, no. 7: 68. https://doi.org/10.3390/children7070068