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B439 Comparison of dexmedetomidine and propofol for procedural analgosedation in children undergoing ultrasound-guided regional anesthesia for orthopedic surgery. A pilot study
  1. M Stevic1,
  2. N Ristic1,
  3. E Bosinci2,
  4. I Petrov Bojicic1,
  5. M Jovanovski Srceva3,
  6. I Budic4,
  7. V Marjanovic4,
  8. D Simic1 and
  9. S Ducic1
  1. 1Medical Faculty University of Belgrade, University children’s hospital, Belgrade, Serbia
  2. 2University children’s hospital, Belgrade, Serbia
  3. 3Ss.”Cyril and Methodious”, UKIM, University in Skopje, Medical Faculty, Skopje, North Macedonia University Clinic for Anesthesia Reanimation and Intensive Care, Skopje, North Macedonia, Skopje, North Macedonia, The Republic of
  4. 4Department of Surgery and Anesthesiology, Faculty of Medicine, University of Nis, Serbia Clinic for Anesthesia and Intensive Therapy, Clinical Centre Nis, Serbia, Nis, Serbia


Background and Aims Ultrasound-guided regional anesthesia and peripheral nerve catheters for postoperative pain management is a relatively recent aspect of the field of pediatric anesthesia. The goal of this prospective, blinded study was to evaluate cardiovascular and respiratory safety, clinical efficacy, and recovery following orthopedic surgery performed in peripheral nerve blocks using dexmedetomidine and propofol for sedation with spontaneous breathing.

Methods The study included 90 children aged 1 to 18 who were randomly assigned to the dexmedetomidine or propofol groups, ASA-PS scores of I to III, since January 2022. We analyzed baseline characteristics: gender, age, body weight, hemodynamic and respiratory stability, the depth of anesthesia was determined with a modified Ramsay sedation score, presence of peripheral nerve catheter, duration of operation and anesthesia, and awakening time from anesthesia.

Results The operation time was longer in the dexmedetomidine group (t = -2.988, DF = 88, p <0.01). The time of anesthesia was longer in the dexmedetomidine group (t = -22.301, DF = 88, p <0.05). Awakening time from anesthesia was longer in the propofol group (t = 10,884, DF = 88, p <0.01). Patients with neuromuscular disorders had a longer awakening time from anesthesia in the propofol group (t = -4808, DF = 43, p<0.01).

Conclusions Our research has shown that dexmedetomidine and propofol are effective and safe for sedation in pediatric patients undergoing orthopedic surgery under regional anesthesia. Due to the rapid awakening from anesthesia, dexmedetomidine is the sedative of choice for patients with neuromuscular disorders.

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