Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 7, Number 3, March 2016, pages 109-113

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


Table 1. Previous Reports of Dexmedetomidine-Remifentanil for General Anesthesia
Authors and reference numberPatient demographicsIntraoperative care
Moharir and Tobias [14]An 11-year-old patient with Duchenne muscular dystrophy for cardiac catheterizationDexmedetomidine and remifentanil were started at 0.7 μg/kg/h and 0.1 μg/kg/min, respectively without bolus dosing. After ensuring an adequate depth of sedation (approximately 10 min), the groin was infiltrated with 1% lidocaine prior to cannula placement. The procedure was completed in 45 min. The dexmedetomidine and remifentanil infusions were discontinued. The patient was awake and conversing within 5 min. The post-procedure course was unremarkable.
Burnett and Schwartz [13]A 10-year-old girl with mitochondrial myopathy and dystonia, who required anesthetic care during a urological procedureAnesthesia was induced with intravenous dexmedetomidine (1 μg/kg), midazolam (0.05 mg/kg), and ketamine (1.2 mg/kg). Rocuronium (0.5 mg/kg) was administered to facilitate endotracheal intubation. Maintenance anesthesia consisted of a dexmedetomidine infusion (0.5 - 1.0 μg/kg/h) and a remifentanil infusion (0.2 - 0.4 μg/kg/min). The surgical duration was 4 h. The post-procedure course was unremarkable.
Suleman et al [27]A 19-year-old male with Leigh’s syndrome scheduled for dental rehabilitationFollowing 70% N2O/O2, dexmedetomidine (1 μg/kg) and fentanyl were administered followed by endotracheal intubation. An­esthesia was maintained with N2O, dexmedetomidine (0.4 - 1.4 μg/kg/h) and remifentanil (0.8 - 1.2 μg/kg/min). The procedure was approximately 1 h. The post-procedure course was unremarkable.