A recently published meta-analysis has concluded that Dexmedetomidine could be useful in reducing psychomotor agitation at wake-up time of children undergoing general anesthesia using Sevoflurane.

There is extensive use of Sevoflurane in pediatric anesthesia because of its effective properties. As it provides quick inhalational induction and awakening from anesthesia as well less hepatotoxic and shows hemodynamic stability. However, it is also known to cause a high incidence of psychomotor agitation. Agitation is characterized by a dissociated state of consciousness, wherein children become inconsolable, irritable, uncooperative and sometimes aggressive. Dexmedetomidine (DEX) has been used, during these conditions, but its actual benefit and implications are still not clear.

Therefore, a meta-analysis was performed to assess the effects of DEX on agitation in children undergoing general anesthesia with sevoflurane. The meta-analysis involved randomized clinical and double-blind studies searched through databases like PubMed, with children (aged below 10 years) undergoing elective procedures under general anesthesia with sevoflurane, using DEX or placebo. Duplicate articles involving children who were receiving premedication and use of active control were excluded from the study. DerSimonian-Laird testing and odds ratio (OR) calculation for dichotomous variables and the standardized mean difference for continuous variables, with their respective 95% confidence interval (CI) were adopted.

Out of total 146 studies identified, 10 were selected which included 558 patients (282 in DEX group and 276 controls).

The result showed that using DEX was considered to be a protective factor for psychomotor agitation (OR=0.17; 95% CI 0.13-0.23; p<0.0001) and nausea and vomiting in Post Anaesthesia Care Unit (PACU) (OR=0.49; 95% CI 0.35-0.68; p<0.0001). It was also found that time to wake-up and PACU discharge time were higher in case of DEX group. No difference was observed between groups for extubation time and duration of anesthesia.

Therefore, it can be concluded that DEX is effective in reducing psychomotor agitation at wake-up time of children undergoing general anesthesia with Sevoflurane.