Background: This study was designed to compare the efficacy of an intraoperative single dose administration of\ntramadol and dexmedetomidine on hemodynamics and postoperative recovery profile including pain, sedation,\nemerge reactions in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia.\nMethods: Seventy-seven patient, aged 2ââ?¬â??12, undergoing adenotonsillectomy with sevoflurane anesthesia was\nenrolled in this study. Patients were randomly assigned to receive either intravenous 2 mg/kg tramadol (Group T;\nn = 39) or 1 Ã?¼g/kg dexmedetomidine (Group D; n = 38) after intubation. Heart rates (HR), mean arterial pressure\n(MAP) were recorded before induction, at induction and every 5 min after induction. Observational pain scores\n(OPS), pediatric anesthesia emergence delirium (PAED) scores, percentage of patients with OPS ââ?°Â¥ 4 or PAED scale\nitems 4 or 5 with an intensity of 3 or 4, and Ramsay sedation scores (RSS) were recorded on arrival to the\npostoperative care unit (PACU) and at 5, 10, 15, 30, 45, 60 min. Extubation time and time to reach Alderete score >\n9 were recorded.\nResults: Dexmedetomidine significantly decreased the HR and MAP 10 and 15 min after induction; increased the\nRSS 15, 30 and 45 min after arrival to PACU. OPS and PAED scores and percentage of patients with OPS ââ?°Â¥4 or\nPAED scale items 4 or 5 with an intensity of 3 or 4 in both groups did not show any significant difference.\nExtubation time and time to have Alderete score > 9 was significantly longer in Group D.\nConclusion: Both tramadol and dexmedetomidine were effective for controlling pain and emergence agitation.\nWhen compared with tramadol intraoperative hypotension, bradycardia and prolonged sedation were problems\nrelated with dexmedetomidine administration.
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