Seguridad y eficacia de dexmedetomidina, fentanil, propofol, lidocaína y manejo del dolor posoperatorio, en cirugía de escoliosis en pacientes pediátricos

From April 7, 2021 to July 20, 2022, 21 pediatric patients between 4 and 18 years old who underwent surgery because of idiopathic scoliosis, were collected. In all cases, pregabalin at a dose of 3,5 mg/kg was used as a preoperative scheme by the hospital’s neuropediatric team, as part of perioperative pain management. The anesthetic protocol used, as the anesthesia base, dexmedetomidine, associated with fentanyl, propofol and lidocaine, as total intravenous anesthesia. We believe that the most important thing is the use of dexmedetomidine in this type of surgery however, its potential protective effect on neurodevelopment is known wich has been responsive for the fact that this drug, with is sedative and analgesic affect, has been shown in recent years as a posible alternative in neonates; its administration, in fetal and neonatal animal models, has been shown not to induce neuroapoptosis and even to the decrease neurotoxicity caused by volatile anesthetics[]. There are very few reports about the use of this drug in pediatric patients. This pharmacological scheme showed good hemodynamic stability throughout the surgical anesthetic process. In all cases blood transfusion was needed based on the compatible globular package, fresh frozen plasma and platelet concentrate (1.1.1) according to the calculation of maximum allowable blood loss. And, as part of the perioperative management scheme, in order to control the postoperative pain, trans-operative subarachnoid morphine was used at a dose of 2 ug/Kg. For most patients, this scheme allowed them to be extubated at the end of the procedure and moved to intensive therapy. In most cases, the stay in the Pediatric Intensive Care Unit was no longer than 48 hours.