During Tonsillectomy and Adenoidectomy, Children with Obstructive Sleep Apnea Syndrome are Given a Dexmedetomidine Infusion to Help with Pain Management and to Avoid Emerging Agitation


  • Sumaya Alwan Salman Senior Specialist in Anaesthesia & Intensive Care, Al-Imamain Al-Kadhimain Medical City
  • Eahab Nabeel Khamees Senior Specialist in Anaesthesia & Intensive Care, Abi Ghraib General Hospital
  • Maha Sabri Younis Senior Specialist in Anaesthesia & Intensive Care, Al-Imamain Al-Kadhimain Medical City


tonsillectomy, adenoidectomy, obstructive sleep apnea syndrome, dexmedetomidine


An α2-specific agonist is the medication used to control analgesia; it has been demonstrated to be beneficial in reducing the amount of opioids needed and reducing emergence agitation. The purpose of this study was to evaluate the relative benefits of continuous intraoperative infusion of dexmedetomidine vs a single dose of fentanyl during surgery for avoiding emerging agitation and perioperative painkiller usage in children with OSA undergoing adenotonsillectomy.


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K. A. Brown, “What we don’t know about childhood obstructive sleep apnoea,” Pediatric Anesthesia, 2001, doi: 10.1046/j.1460-9592.2001.00719.x.

S. A. McColley, M. M. April, J. L. Carroll, and ..., “Respiratory compromise after adenotonsillectomy in children with obstructive sleep apnea,” … –Head &Neck …, 1992, [Online]. Available: https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/620969

K. A. Brown, A. Laferriere, I. Lakheeram, and ..., “Recurrent hypoxemia in children is associated with increased analgesic sensitivity to opiates,” The Journal of the …, 2006, [Online]. Available: https://pubs.asahq.org/anesthesiology/article-abstract/105/4/665/6803

T. Voepel-Lewis, S. Malviya, and A. R. Tait, “A prospective cohort study of emergence agitation in the pediatric postanesthesia care unit,” Anesthesia &analgesia, 2003, [Online]. Available: https://journals.lww.com/anesthesia-analgesia/FullText/2003/06000/A_Prospective_Cohort_Study_of_Emergence_Agitation.16.aspx

B. Tufanogullari, P. F. White, M. P. Peixoto, and ..., “Dexmedetomidine infusion during laparoscopic bariatric surgery: the effect on recovery outcome variables,” Anesthesia & …, 2008, [Online]. Available: https://journals.lww.com/anesthesia-analgesia/fulltext/2008/06000/dexmedetomidine_infusion_during_laparoscopic.21.aspx

J. E. Hall, T. D. Uhrich, J. A. Barney, S. R. Arain, and ..., “Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions,” Anesthesia & …, 2000, [Online]. Available: https://journals.lww.com/anesthesia-analgesia/fulltext/2000/03000/sedative,_amnestic,_and_analgesic_properties_of.35.aspx

C. Dawson, D. Ma, A. Chow, and M. Maze, “Dexmedetomidine enhances analgesic action of nitrous oxide: mechanisms of action,” The Journal of the American …, 2004, [Online]. Available: https://pubs.asahq.org/anesthesiology/article-abstract/100/4/894/7849

K. P. Mason, D. Zurakowski, S. E. Zgleszewski, and ..., “High dose dexmedetomidine as the sole sedative for pediatric MRI,” Pediatric …, 2008, doi: 10.1111/j.1460-9592.2008.02468.x.

E. Deutsch and J. D. Tobias, “Hemodynamic and respiratory changes following dexmedetomidine administration during general anesthesia: sevoflurane vs desflurane,” Pediatric Anesthesia, 2007, doi: 10.1111/j.1460-9592.2006.02139.x.

G. Guler, A. Akin, Z. Tosun, S. Ors, and ..., “Single‐dose dexmedetomidine reduces agitation and provides smooth extubation after pediatric adenotonsillectomy,” Pediatric …, 2005, doi: 10.1111/j.1460-9592.2004.01541.x.

F. Erdil, S. Demirbilek, Z. Begec, and ..., “The effects of dexmedetomidine and fentanyl on emergence characteristics after adenoidectomy in children,” … and intensive care, 2009, doi: 10.1177/0310057X0903700405.

K. E. McGoldrick, “Effects of Postoperative, Nonsteroidal Anti-Inflammatory Drugs on Bleeding Risk After Tonsillectomy: Meta-Analysis of Randomized, Controlled Trials,” Survey of Anesthesiology, 2003, [Online]. Available: https://journals.lww.com/surveyanesthesiology/fulltext/2003/12000/effects_of_postoperative,_nonsteroidal.1.aspx

Ö. L. Erhan, H. Göksu, C. Alpay, and A. Beştaş, “Ketamine in post-tonsillectomy pain,” International journal of pediatric …, 2007, [Online]. Available: https://www.sciencedirect.com/science/article/pii/S0165587607000183

B. J. Hullett, N. A. Chambers, E. M. Pascoe, and ..., “Tramadol vs morphine during adenotonsillectomy for obstructive sleep apnea in children,” Pediatric …, 2006, doi: 10.1111/j.1460-9592.2005.01827.x.

R. Korpela, P. Korvenoja, and O. A. Meretoja, “Morphine-sparing effect of acetaminophen in pediatric day-case surgery,” The Journal of the American …, 1999, [Online]. Available: https://pubs.asahq.org/anesthesiology/article-abstract/91/2/442/37353

C. E. Afman, J. A. Welge, and ..., “Steroids for post-tonsillectomy pain reduction: meta-analysis of randomized controlled trials,” … —Head and Neck Surgery, 2006, doi: 10.1016/j.otohns.2005.11.010.

J. C. Sanders, M. A. King, R. B. Mitchell, and ..., “Perioperative complications of adenotonsillectomy in children with obstructive sleep apnea syndrome,” Anesthesia & …, 2006, [Online]. Available: https://journals.lww.com/anesthesia-analgesia/fulltext/2006/11000/Perioperative_Complications_of_Adenotonsillectomy.10.aspx

M. Shukry, M. C. Clyde, P. L. Kalarickal, and ..., “Does dexmedetomidine prevent emergence delirium in children after sevoflurane‐based general anesthesia?,” Pediatric …, 2005, doi: 10.1111/j.1460-9592.2005.01660.x.

R. S. Hannallah, L. M. Broadman, A. B. Belman, and ..., “Comparison of caudal and ilioinguinal/iliohypogastric nerve blocks for control of post-orchiopexy pain in pediatric ambulatory surgery,” The Journal of the …, 1987, [Online]. Available: https://pubs.asahq.org/anesthesiology/article-abstract/66/6/832/29622

N. Sikich and J. Lerman, “Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale,” The Journal of the American Society of …, 2004, [Online]. Available: https://pubs.asahq.org/anesthesiology/article-abstract/100/5/1138/6415

J. W. Cole, D. J. Murray, J. D. McALLISTER, and ..., “Emergence behaviour in children: defining the incidence of excitement and agitation following anaesthesia,” Pediatric …, 2002, doi: 10.1046/j.1460-9592.2002.00868.x.

G. C. Petroz, N. Sikich, M. James, H. van Dyk, and ..., “A phase I, two-center study of the pharmacokinetics and pharmacodynamics of dexmedetomidine in children,” The Journal of the …, 2006, [Online]. Available: https://pubs.asahq.org/anesthesiology/article-abstract/105/6/1098/6896

M. E. Ibacache, H. R. Muñoz, V. Brandes, and ..., “Single-dose dexmedetomidine reduces agitation after sevoflurane anesthesia in children,” Anesthesia & …, 2004, [Online]. Available: https://journals.lww.com/anesthesia-analgesia/fulltext/2004/01000/Single_Dose_Dexmedetomidine_Reduces_Agitation.15.aspx

G. P. Vlajkovic and R. P. Sindjelic, “Emergence delirium in children: many questions, few answers,” Anesthesia &Analgesia, 2007, [Online]. Available: https://journals.lww.com/anesthesia-analgesia/fulltext/2007/01000/emergence_delirium_in_children__many_questions,.18.aspx

A. Gurbet, M. Basağan, G. Türker, and ..., “Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements,” Canadian Journal …, 2006, [Online]. Available: https://acikerisim.uludag.edu.tr/handle/11452/21426

I. T. Cohen, J. C. Finkel, R. S. Hannallah, and ..., “The effect of fentanyl on the emergence characteristics after desflurane or sevoflurane anesthesia in children,” Anesthesia & …, 2002, [Online]. Available: https://journals.lww.com/anesthesia-analgesia/fulltext/2002/05000/the_effect_of_fentanyl_on_the_emergence.23.aspx

D. Tomic, “The burden and risks of emerging complications of diabetes mellitus,” Nat Rev Endocrinol, vol. 18, no. 9, pp. 525–539, 2022, doi: 10.1038/s41574-022-00690-7.

W. Trzepizur, “Sleep Apnea–Specific Hypoxic Burden, Symptom Subtypes, and Risk of Cardiovascular Events and All-Cause Mortality,” Am J Respir Crit Care Med, vol. 205, no. 1, pp. 108–117, 2022, doi: 10.1164/rccm.202105-1274OC.

P. Salminen, “Effect of Laparoscopic Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass on Weight Loss, Comorbidities, and Reflux at 10 Years in Adult Patients with Obesity: The SLEEVEPASS Randomized Clinical Trial,” JAMA Surg, vol. 157, no. 8, pp. 656–666, 2022, doi: 10.1001/jamasurg.2022.2229.

A. Agustí, “Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary,” Am J Respir Crit Care Med, vol. 207, no. 7, pp. 819–837, 2023, doi: 10.1164/rccm.202301-0106PP.




How to Cite

Salman, S. A., Khamees, E. N., & Younis, M. S. (2024). During Tonsillectomy and Adenoidectomy, Children with Obstructive Sleep Apnea Syndrome are Given a Dexmedetomidine Infusion to Help with Pain Management and to Avoid Emerging Agitation. INTERNATIONAL JOURNAL OF HEALTH SYSTEMS AND MEDICAL SCIENCES, 3(2), 18–30. Retrieved from https://inter-publishing.com/index.php/IJHSMS/article/view/3479