الفهرس 
Children’s Hospital of Eastern Ontario Pain ScaleOnly 14 pages are availabe for public view
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Abstract
Hypospadias surgery is one of the most common urologic surgical procedures done in children. It is very painful leading to many perioperative adverse outcomes like anxiety, stress response, pain, agitation, nausea, and affect wound healing up to prolonged hospitalization. Dexmedetomidine is a α2-adrenergic receptor agonist that has an opioid-sparing effect that has been used in children for many anesthetic purposes in different doses with or without a bolus dose.
Aim and objectives; to show the effect of dexmedetomidine infusion without giving a bolus dose on SPI in pediatrics undergoing hypospadias repair intraoperative and at PACU discharge.
Subjects and methods; 90 patients aged 1 to 7 years old scheduled for hypospadias repair was randomly assigned into 2 groups, group D- dexemedetomidine group (45), group C-control group (45), this study conducted at Fayoum University.
Result; SPI, regarding blood pressure, SBP, DBP and FLACC in all timepoints were significantly lower in dexmedetomidine group compared to control group, (P<0.001). HR at baseline, after intubation, skin incision and at PACU discharge was significantly lower in dexmedetomidine group compared to control group, (P<0.05). Anesthesia time and extubation time were significantly higher in dexmedetomidine group compared to control group, (P<0.001). Incidence of hypotension and incidence of bradycardia were significantly higher in dexmedetomidine group compared to control group, (P<0.001).
Conclusion; In conclusion, our study demonstrates that the intraoperative use of dexmedetomidine in pediatric hypospadias surgery patients decreases the intraoperative and postoperative analgesic requirements up to 24 h postoperatively. The use of this regimen was well tolerated and did not lead to an increase in the incidence of hemodynamic side effects and had a favorable patient calming effect in the immediate postoperative course.
Keywords; Hypospadias surgery, Dexmedetomidine, perioperative adverse outcomes, surgical pleth index (SPI).