The Effect of Dexmedetomidine on Oxygen During One Lung Ventilation in Pediatric Surgery. (RCT)
One Lung Ventilation OLV, Esophageal Atresia, Hydrocystoma
About this trial
This is an interventional treatment trial for One Lung Ventilation OLV focused on measuring Dexmedetomidine, One lung ventilation OLV, Hypoxic pulmonary vasoconstriction HPV, Pulmonary shunt fraction Qs / Qt
Eligibility Criteria
Inclusion Criteria:
- As per the American Society of Anesthesiologists (ASA) classification I-I physical condition children undergoing thoracic surgery with OLV.
- From one day old to 12 years old.
- There is no prejudice in terms of gender.
- This study practically does not exclude any child who will undergo OLV even in the presence of cardiac, renal or hepatic diseases.
Or even in the presence of cardiac stimulants and supports (dopamine or dopamine), provided that the general condition is stable, which allows surgery and OLV.
Exclusion Criteria:
- Premature infants: due to immaturity of the lung and insufficient formation of the surfactant.
- Cystic Fibrosis: The depressor for surfactant and lung immaturity is not permitted to perform the OLV technique
- There is no contraindication for the administration of dexmedetomidine in children except those who show signs of allergy to the dexmedetomidine.
- This study does not exclude practically any child who will undergo OLV.
- During operating surgery: The child is excluded from the study if hypoxia occurs (SpO2 <90%) and did not respond to maneuvers and anesthetic techniques (Increase PEEP Increase the FLOW, Tidal volume, increase Vt, Pmax increased pressure, FiO2 increased) Then the lungs are periodically ventilated with positive pressure, and the OLV technique is switched off and the child is excluded from the pilot study.
- During operating surgery: If there is a drop-in heart rate less than 60 beats / minute and it does not respond to atropine or an increased dose of Cardiac tonics (dopamine).
At this time the infusion of dexmedetomidine is stopped, it is assumed that there is no very slow pulse, and if it does, it is likely that the primary cardiac lesion is the cause.
Sites / Locations
- University Children's Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
The dexmedetomidine group:
The Placebo group (the control group):
An initial dose of 1 mcg / kg 1 dexmedetomidine will be given 10 minutes after the start of anesthesia infusion within 10 minutes, after which the dexmedetomidine infusion is maintained at a dose of 0.4 mcg / kg / hour. The injection will be stopped before the skin is closed.
After the same anesthesia, the same amount of Saline solution will be administered, instead of dexmedetomidine, with the same protocol.