Saeedeh Mokhtari
Tehran University of Medical Sciences, Iran
Biography
Objectives: To compare the effect of intravenous dexamethasone and intravenous acetaminophen (Apotel) on oral pain, agitation, sore throat, nausea/vomiting and recovery time after dental rehabilitation under general anesthesia in children.
Materials and methods: A total of 60 ASA I, II children in need of dental treatment under general anesthesia in the age range of 2-6 years were included in this prospective double-blinded clinical trial study. All children received 0.5 mg/kg oral midazolam 15 minutes before the intervention. Standard anesthesia techniques including inhalation induction with sevoflurane, followed by venipuncture and intravenous fentanyl l µg/kg and atracurium 0.5 mg/kg were used. Patients were randomly divided into two groups. After induction of anesthesia, the first group received 0.5 mg/kg intravenous dexamethasone and the second group received 15 mg/kg intravenous acetaminophen.
Results: The median recovery time in the Apotel group was significantly shorter (90 vs. 115; p-value<0.001). However, the dexamethasone group showed significantly less agitation (9 vs. 12; p-value=0.005). There was no difference between the two groups in terms of oral pain and sore throat. Dexamethasone group showed less nausea/vomiting during recovery (p-value=0.005) but in 24-hour follow-up, nausea/vomiting showed no significant difference between the two groups (p-value=0.23).
Conclusion: Dexamethasone is a more appropriate intervention compared to Apotel despite the longer recovery time, due to less agitation and nausea and vomiting during recovery. However, it has no advantage over Apotel in terms of reducing mouth pain and sore throat.
Keywords: Acetaminophen, Agitation, Dentistry for children, Dexamethasone, Emergence, General anesthesia, Pain, Paracetamol, PONV.