• Marco Aurélio Soares Amorim, Catia Sousa Govêia, Edno Magalhães, Luís Cláudio Araújo Ladeira, Larissa Govêia Moreira, and Miranda Denismar Borges de DB Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil; Universidade Federal de Goiás (UFG), Instituto de Medicina Tropical.
• Centro de Ensino e Treinamento José Quinan, Goiânia, GO, Brazil. Electronic address: marcomc18@hotmail.com.
• Braz J Anesthesiol. 2017 Mar 1; 67 (2): 193-198.

Background And ObjectivesSevoflurane is often used in pediatric anesthesia and is associated with high incidence of psychomotor agitation. In such cases, dexmedetomidine (DEX) has been used, but its benefit and implications remain uncertain. We assessed the effects of DEX on agitation in children undergoing general anesthesia with sevoflurane.MethodMeta-analysis of randomized clinical and double-blind studies, with children undergoing elective procedures under general anesthesia with sevoflurane, using DEX or placebo. We sought articles in English in PubMed database using the following terms: Dexmedetomidine, sevoflurane (Methyl Ethers/sevoflurante), and agitation (Psychomotor Agitation). Duplicate articles with children who received premedication and used active control were excluded. It was adopted random effects model with DerSimonian-Laird testing and odds ratio (OR) calculation for dichotomous variables, and standardized mean difference for continuous variables, with their respective 95% confidence interval (CI).ResultsOf 146 studies identified, 10 were selected totaling 558 patients (282 in DEX group and 276 controls). The use of DEX was considered a protective factor for psychomotor agitation (OR=0.17; 95% CI 0.13-0.23; p<0.0001) and nausea and vomiting in PACU (OR=0.49; 95% CI 0.35-0.68; p<0.0001). Wake-up time and PACU discharge time were higher in the dexmedetomidine group. There was no difference between groups for extubation time and duration of anesthesia.ConclusionDexmedetomidine reduces psychomotor agitation during wake-up time of children undergoing general anesthesia with sevoflurane.Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

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