Pediatric anesthesia & critical care
Short-term Outcomes in Infants after General Anesthesia with Low-dose Sevoflurane/Dexmedetomidine/Remifentanil versus Standard-dose Sevoflurane (the TREX Trial)
Primary result · Intraoperative hypotensionResult — go to the resultRisk difference −11.6% 95% CI −18.9 to −4.3%Authors' conclusion
These early postoperative results suggest that in children less than 2 yr of age receiving greater than 2 h of general anesthesia, the low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia technique and the standard sevoflurane anesthesia technique are broadly clinically similar, with no clear evidence to support choosing one technique over the other.
Study context
- Population
- Infants <2 yr expected to undergo GA for at least 2 h, 20 centres in Australia, Italy and the US
- Participants
- 455 infants
- Comparison
- Low-dose sevoflurane/dexmedetomidine/remifentanil vs standard-dose sevoflurane anaesthesia
- Primary endpoint
- Short-term perioperative outcomes: intraoperative hypotension and bradycardia, postoperative pain, time to recovery, light anesthesia, morbidity and mortality
- Follow-up
- 5 days
Methodological detailsphase III, active controlled, parallel group, assessor blinded, multicentre, superiority
- Phase III
- Active controlled
- Parallel group
- Assessor blinded
- Multicentre
- Superiority
Primary result
Intraoperative hypotension
Risk difference
−11.6%
95% CI −18.9 to −4.3%
Low-dose sevoflurane/dexmedetomidine/remifentanil vs Standard-dose sevoflurane
risk difference −11.6% (95% CI −18.9 to −4.3%)
As reported in the abstract
Further findings
Time from eye opening to PACU discharge
- Similar in both arms
Morbidity and mortality · 5 days
- Similar in both arms
Safety
| Outcome | Risk difference (95% CI) | |
|---|---|---|
| Bradycardia | 18.2% (8.8–27.7%) | |
| −2002040Difference (linear scale) |
Events
| Outcome | Low-dose sevoflurane/dexmedetomidine/remifentanil | Standard-dose sevoflurane |
|---|---|---|
| Episodes of light anaesthesia | 89 | 4 |
| Protocol abandonments | 1 | 0 |
| Life-threatening eventNeither suffered long-term sequelae | 1 | 1 |
Original publication
Short-term Outcomes in Infants after General Anesthesia with Low-dose Sevoflurane/Dexmedetomidine/Remifentanil versus Standard-dose Sevoflurane (the TREX Trial). Anesthesiology. Published 16 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →