General Anesthesia With Dexmedetomidine and Remifentanil in a 3-Year-Old Child: An Alternative Anesthetic Regimen to Allay Parental Concerns of the Potential Neurocognitive Effects of General Anesthesia

Hina Walia, Emmett Whitaker, Gregory Pearson, Joseph D. Tobias

Abstract


Recent attention has been focused on the potential neurocognitive effects of general anesthesia during infancy and early life. Although the exact implications of this effect have yet to be proven, media attention has been raised and parents may be aware of such problems, thereby questioning the safety of general anesthesia. Although spinal and regional anesthetic techniques have seen an increased use in an attempt to eliminate the concerns of such problems, many surgical procedures may not be amenable to regional anesthesia. We present a 3-year-old boy who presented for excision of an enlarging cyst on his left ear. During the preoperative visit with the surgeon, the patient’s mother voiced concerns regarding the potential neurocognitive effects of general anesthesia. General anesthesia was provided using a combination of dexmedetomidine and remifentanil. Previous reports of the use of this unique combination of agents are reviewed and its role in this scenario was discussed.




J Med Cases. 2016;7(3):109-113
doi: https://doi.org/10.14740/jmc2453w

Keywords


Dexmedetomidine; Remifentanil; Pediatric anesthesia; Neurotoxicity

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