The Effects of Dexmedetomidine and Tramadol on Extubation Quality and Postoperative Pain and Agitation in Pediatric Patients Undergoing Adenotonsillectomy Surgery

Patients were taken to pre-operative preparation room with their parents about 30 minutes before the surgical operation. 0.4 mg/kg midazolam was given orally to the all patients in preparation room. Then, patients were monitored and taken to the operation room. Anesthesia was induced with 8% inspired sevoflurane in 50% nitrous oxide and 50% oxygen. After anesthesia induction, sevoflurane concentration is gradually reduced and an intravenous (i.v.) catheter was inserted. Patients were assigned to dexmedetomidine or tramadol group according to a computer generated program as follows: dexmedetomidine group (group D, n = 30) and tramadol group (group T, n = 30). Patients in group D received 1 µg/kg dexmedetomidine and patients in group T received 1.5 mg/kg tramadol. Both of these drugs were administered with a 10-minute i.v. infusion about 10 minutes before the end of the surgery. Patients were monitored, and mean arterial pressure (MAP) and heart rate (HR) were recorded. In addition to these variables, the Riker Sedation-Agitation Scale (SAS) was used for determining the level of anxiety of the patients, and pain point scale was used for determining the level of pain of the patients. Moreover, extubating time which was defined as the time from discontinuation of inhalation agent to removal of the endotracheal tube and extubation quality which was assessed by the presence of the following not breathing (> 20 second), coughing-bucking (frequency =4) and desaturation (saturation of O2 < 95%) after the extubation period were recorded for all patients. Dexmedetomidin group and tramadol groups were compared in terms of these variables. Anaesthetist will be administering the intervention.