دورية أكاديمية
أعرض في EDS

Association of dexmedetomidine use with haemodynamics, postoperative recovery, and cost in paediatric anaesthesia: a hospital registry study.

التفاصيل البيبلوغرافية
العنوان: Association of dexmedetomidine use with haemodynamics, postoperative recovery, and cost in paediatric anaesthesia: a hospital registry study.
المؤلفون: Azimaraghi O; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Rudolph MI; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department for Anesthesiology and Intensive Care Medicine, Germany., Luedeke CM; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Ramishvili T; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Jaconia GD; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Scheffenbichler FT; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Anesthesiology and Intensive Care Medicine, Ulm University, Ulm, Germany., Chambers TA; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Karaye IM; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Population Health, Hofstra University, Hempstead, NY, USA., Eikermann M; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Anesthesiology and Intensive Care Medicine, University of Duisburg-Essen, Essen, Germany. Electronic address: meikermann@montefiore.org., Chao J; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA., Jackson WM; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
المصدر: British journal of anaesthesia [Br J Anaesth] 2024 Aug; Vol. 133 (2), pp. 326-333. Date of Electronic Publication: 2024 Apr 17.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: England NLM ID: 0372541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-6771 (Electronic) Linking ISSN: 00070912 NLM ISO Abbreviation: Br J Anaesth Subsets: MEDLINE
أسماء مطبوعة: Publication: 2018- : [London] : Elsevier
Original Publication: London, Eng. [etc.]
مواضيع طبية MeSH: Dexmedetomidine*/therapeutic use , Registries* , Hypnotics and Sedatives*/economics , Hemodynamics*/drug effects , Length of Stay*/statistics & numerical data , Anesthesia Recovery Period*, Humans ; Child, Preschool ; Infant ; Female ; Male ; Child ; Infant, Newborn ; Anesthesia/economics ; Anesthesia/methods ; Retrospective Studies ; Health Care Costs/statistics & numerical data ; Dose-Response Relationship, Drug ; Pediatric Anesthesia
مستخلص: Background: Dexmedetomidine utilisation in paediatric patients is increasing. We hypothesised that intraoperative use of dexmedetomidine in children is associated with longer postanaesthesia care unit length of stay, higher healthcare costs, and side-effects.
Methods: We analysed data from paediatric patients (aged 0-12 yr) between 2016 and 2021 in the Bronx, NY, USA. We matched our cohort with the Healthcare Cost and Utilization Project-Kids' Inpatient Database (HCUP-KID).
Results: Among 18 104 paediatric patients, intraoperative dexmedetomidine utilisation increased from 51.7% to 85.7% between 2016 and 2021 (P<0.001). Dexmedetomidine was dose-dependently associated with a longer postanaesthesia care unit length of stay (adjusted absolute difference [AD adj ] 19.7 min; 95% confidence interval [CI]: 18.0-21.4 min; P<0.001, median length of stay of 122 vs 98 min). The association was magnified in children aged ≤2 yr undergoing short (≤60 min) ambulatory procedures (AD adj 33.3 min; 95% CI: 26.3-40.7 min; P<0.001; P-for-interaction <0.001). Dexmedetomidine was associated with higher total hospital costs of USD 1311 (95% CI: USD 835-1800), higher odds of intraoperative mean arterial blood pressure below 55 mm Hg (adjusted odds ratio [OR adj ] 1.27; 95% CI: 1.16-1.39; P<0.001), and higher odds of heart rate below 100 beats min -1 (OR adj 1.32; 95% CI: 1.21-1.45; P<0.001), with no preventive effects on emergence delirium requiring postanaesthesia i.v. sedatives (OR adj 1.67; 95% CI: 1.04-2.68; P=0.034).
Conclusions: Intraoperative use of dexmedetomidine is associated with unwarranted haemodynamic effects, longer postanaesthesia care unit length of stay, and higher costs, without preventive effects on emergence delirium.
Competing Interests: Declaration of interest The authors declare that they have no conflicts of interest.
(Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
فهرسة مساهمة: Keywords: dexmedetomidine; emergence delirium; healthcare cost; paediatric anaesthesia; postanaesthesia care unit; surgery
المشرفين على المادة: 67VB76HONO (Dexmedetomidine)
0 (Hypnotics and Sedatives)
تواريخ الأحداث: Date Created: 20240417 Date Completed: 20240714 Latest Revision: 20240714
رمز التحديث: 20240715
DOI: 10.1016/j.bja.2024.03.016
PMID: 38631942
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-6771
DOI:10.1016/j.bja.2024.03.016