ArticleSaudi journal of anaesthesia
Effectiveness of dexmedetomidine versus fentanyl on postoperative pain and recovery after pediatric tonsillectomy: A retrospective cohort study.
Article in Saudi journal of anaesthesia. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Pediatric tonsillectomy is commonly associated with significant postoperative pain. Opioids remain a mainstay for perioperative analgesia but carry risks of respiratory depression and prolonged recovery, especially in patients with obstructive sleep apnea (OSA). Dexmedetomidine, an alpha-2 adrenergic agonist, provides sedation and analgesia with minimal respiratory depression. Objective: To compare intraoperative induction with fentanyl versus dexmedetomidine and their effects on postoperative pain, post-anesthesia care unit (PACU) length of stay, and opioid consumption in children undergoing tonsillectomy. Methods: We retrospectively reviewed medical records of pediatric patients aged 3-16 years, who underwent tonsillectomy at King Abdullah Specialized Children's Hospital between January 2024 and December 2024. Patients were grouped by intraoperative induction regimen: fentanyl or dexmedetomidine. Outcomes included PACU pain scores, postoperative opioid use, PACU stay, adverse events, and hospital stay. Shapiro-Wilk was used to test normality; Mann-Whitney U was used when comparing continuous variables, and chi-square/Fisher was used when comparing categorical variables. Controlled logistic and linear regressions were used to adjust for the age, weight, and duration of a surgery. The analyses were conducted using Python 3.10. Results: A total of 250 patients were analyzed (dexmedetomidine Conclusion: Dexmedetomidine induction provides comparable analgesia to fentanyl while reducing adverse events, although it is associated with longer PACU stay. It may represent a safe opioid-sparing option in pediatric tonsillectomy, particularly in high-risk children.
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