Comparison of dexmedetomidine with propofol for sedative effect during sacral block in children

Objective To compare the sedative effect of dexmedetomidine and propofol during sacral block in children,and evaluate the feasibility and safety of dexmedetomidine.Methods Sixty children with hypospadias(ASA ⅠtoⅡ)were randomly divided into propofol group and dexmedetomidine group,with 30 patients in each group.Dexmedetomidine group was administered dexmedetomidine at an initial loading dose of 1μg/kg for 10 minutes followed by a continuous infusion at 0.5μg/(kg·h).Propofol group was administered propofol at a bolus dose of 2 mg/kg for 10 minutes followed by a continuous infusion at 2 mg/(kg·h).The continuous infusion stopped 15 minutes before the end of surgery.The heart rate,mean arterial pressure,intraoperative ketamine consumption and postoperative recovery time were recorded at the time points of T0(before anesthesia),T1(immediately after sacral block),T2(10minutes after administration of anesthetic),T3(30minutes after administration of anesthetic)and T4(at the end of surgery).The sedation scores and the incidence of intraoperative adverse reactions were evaluated.Results At the time points of T2,T3 and T4,the heart rates were lower in dexmedetomidine group((112.8±13.8),(103.4±14.1),(95.7±16.1)beats/min)than those in propofol group((129.2±18.5),(124.1±14.2),(109.6±15.1)beats/min)(P0.05),the mean arterial pressures were higher in dexmedetomidine group((98.5±12.7),(92.4±12.1),(74.9±8.2)mm Hg)than those in propofol group((84.6±11.7),(78.5±11.5),(67.9±8.0)mm Hg)(P0.05).The heart rate and mean arterial pressure were more stable in dexmedetomidine group.The ketamine consumption was less in dexmedetomidine group((2.5±0.9)mg/kg)than that in propofol group((5.0±1.7)mg/kg),sedative satisfactory rate was higher in dexmedetomidine group(93.3%)than that in propofol group(63.3%),and the incidence of respiratory depression was lower in dexmedetomidine group(0)than that in propofol group(13.3%)(P0.05).There was no significant difference in postoperative recovery time between two groups(P0.05).Conclusion Dexmedetomidine is superior to propofol for sacral block in hypospadias surgery,with no serious adverse reactions.