Pediatric anesthesia & critical care
Effects of Dexmedetomidine–Remifentanil on Neurodevelopment of Children after Inhalation Anesthesia: A Randomized Clinical Trial
Authors' conclusion
The addition of dexmedetomidine and remifentanil to sevoflurane anesthesia was not associated with significant differences in neurodevelopmental outcomes at 28 to 30 months compared to sevoflurane alone.
Study context
- Population
- Children younger than 2 yr undergoing nonstaged, nonrepetitive surgeries343 completed assessments
- Participants
- 400 participants
- Comparison
- DEX-R vs Control
- DEX-Rn = 176
- Controln = 169reference
- Primary endpoint
- Full-scale IQ (to be reported after completion of long-term follow-up)
- Follow-up
- 5 yr of age
Methodological detailsprospective, double-blind
- Prospective
- Double-blind
Primary result
As reported in the abstract
Full-scale IQ at 5 yr of age
- Primary endpoint will be reported after completion of long-term follow-up
Secondary outcomes
| Outcome | DEX-R | Control | Mean difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Full-scale IQ (Korean Leiter International Performance Scale; predefined secondary) · 28 to 30 monthsMean | 102.5 (SD 11.5) | 103.6 (SD 11.5) | −1.1 (−3.9 to 1.7) | P = 0.442 | |
| Anesthesia durationMean, min | 72.8 | 77.1 | 4.4 (−3.8 to 12.6) | P = 0.293 | |
| −1001020Difference (linear scale) |
| Outcome | DEX-R | Control | Mean difference (vol%) (95% CI) | P value | |
|---|---|---|---|---|---|
| End-tidal sevoflurane concentration | mean 1.8 vol% | mean 2.6 vol% | −0.9 (−1.0 to −0.7) | P < 0.001 | |
| −1.5−1−0.500.5Difference, vol% (linear scale) |
Child Behavior Checklist total score (predefined secondary) · 28 to 30 months
- No significant difference between groups
Original publication
Effects of Dexmedetomidine–Remifentanil on Neurodevelopment of Children after Inhalation Anesthesia: A Randomized Clinical Trial. Anesthesiology. Published 9 September 2025. doi:10.
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