Use of Dexmedetomidine as Adjuvant for the Anesthetic Management of Obese Children with Obstructive Sleep Apnea Undergoing Tonsillectomy and Adenoidectomy

Abstract

Obstructive sleep apnea (OSA) in children is most commonly associated with tonsillar and adenoid hypertrophy. Use of opioids and residual amounts of inhaled agents can cause severe respiratory depression and thus represent an added risk to patients with OSA in the immediate postoperative period. Dexmedetomidine, a specific alpha 2-adrenergic receptor agonist, is known for its hypnotic, sedative, analgesic and sympatholytic properties. It potentiates analgesia with the advantages of minimal respiratory compromise, rapid onset and clearance. Because dexmedetomidine has been shown to be effective as an analgesic and sedative agent while minimizing respiratory compromise, it offers a safer alternative as an adjuvant for the anesthetic management of obese pediatric patients with OSA undergoing tonsillectomy and adenoidectomy.