The effects of dexmedetomidine and tramadol on post‐operative pain and agitation, and extubation quality in paediatric patients undergoing adenotonsillectomy surgery: A randomized trial

Journal of Clinical Pharmacy and TherapeuticsVolume 45, Issue 2 p. 340-346 ORIGINAL ARTICLE The effects of dexmedetomidine and tramadol on post-operative pain and agitation, and extubation quality in paediatric patients undergoing adenotonsillectomy surgery: A randomized trial Ikbal Koceroglu MD, Ikbal Koceroglu MD Department of Dermatology, University Hospital of Erlangen, Erlangen, GermanySearch for more papers by this authorSibel Devrim MD, Sibel Devrim MD Department of Anesthesiology and Reanimation, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeySearch for more papers by this authorTugba Bingol Tanriverdi MD, Corresponding Author Tugba Bingol Tanriverdi MD tuggbabingol@gmail.com orcid.org/0000-0003-1303-9695 Department of Anesthesiology and Reanimation, Mehmet Akif Inan Training and Research Hospital, University of Health Sciences, Sanliurfa, Turkey Correspondence Tugba Bingol Tanriverdi, Department of Anesthesiology and Reanimation, Mehmet Akif Inan Training and Research hospital, University of Health Sciences, Sanliurfa, Turkey. Email: tuggbabingol@gmail.comSearch for more papers by this authorMelek Gura Celik MD, Melek Gura Celik MD Department of Anesthesiology and Reanimation, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeySearch for more papers by this author Ikbal Koceroglu MD, Ikbal Koceroglu MD Department of Dermatology, University Hospital of Erlangen, Erlangen, GermanySearch for more papers by this authorSibel Devrim MD, Sibel Devrim MD Department of Anesthesiology and Reanimation, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeySearch for more papers by this authorTugba Bingol Tanriverdi MD, Corresponding Author Tugba Bingol Tanriverdi MD tuggbabingol@gmail.com orcid.org/0000-0003-1303-9695 Department of Anesthesiology and Reanimation, Mehmet Akif Inan Training and Research Hospital, University of Health Sciences, Sanliurfa, Turkey Correspondence Tugba Bingol Tanriverdi, Department of Anesthesiology and Reanimation, Mehmet Akif Inan Training and Research hospital, University of Health Sciences, Sanliurfa, Turkey. Email: tuggbabingol@gmail.comSearch for more papers by this authorMelek Gura Celik MD, Melek Gura Celik MD Department of Anesthesiology and Reanimation, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeySearch for more papers by this author First published: 04 December 2019 https://doi.org/10.1111/jcpt.13080Citations: 6Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract What is known and objective Adenotonsillectomies are common surgical procedures performed under general anaesthesia in childhood. Post-operative pain and agitation are complications associated with this procedure. We compared the effects of dexmedetomidine and tramadol on post-operative pain, agitation, haemodynamic parameters, and extubation quality in patients undergoing an adenotonsillectomy using sevoflurane as an anaesthetic agent. Methods Sixty paediatric patients who had undergone an adenotonsillectomy were included in this study. The patients were randomized into two groups that received either dexmedetomidine (n = 30) or tramadol (n = 30). Haemodynamic variables, extubation time, post-operative pain, agitation and adverse events were recorded for all patients. Post-operative pain was assessed with the pain point system scale (PPSS), and agitation was assessed using the Riker Sedation-Agitation Scale (SAS). Results Patients in the dexmedetomidine group had significantly lower heart rates than the tramadol group. In addition, patients in the dexmedetomidine group had significantly lower post-operative PPSS and Riker SAS scores than patients in the tramadol group. Not breathing, cough-bucking and desaturation after extubation occurred less frequently in patients who received dexmedetomidine than in patients who received tramadol. However, the time to extubation was significantly longer for patients who received dexmedetomidine. What is new and conclusion Our study demonstrated that dexmedetomidine was more effective than tramadol for mitigating post-operative pain and agitation in paediatric patients following an adenotonsillectomy with sevoflurane. Although dexmedetomidine was associated with a longer time to extubation, it was also associated with fewer complications following extubation compared with tramadol. CONFLICT OF INTEREST None to declare. Citing Literature Volume45, Issue2April 2020Pages 340-346 RelatedInformation