Boston Children's Hospital
This is a prospective, randomized, controlled, non-inferiority study of patients undergoing tonsil surgeries at Boston Children's Hospital Waltham. The overall aim is to evaluate the efficacy of an opioid anesthetic plan (morphine, ketorolac, and acetaminophen versus an opioid sparing anesthetic plan (dexmedetomidine, ketorolac and acetaminophen) for perioperative analgesia and recovery time in patients undergoing tonsillectomies and tonsillotomies at Boston Children's Hospital Waltham. Secondary measures include rescue opioids administered in post-anesthesia care unit (PACU), re-operation secondary to bleeding, emergence delirium, post-operative nausea and vomiting, intraoperative hemodynamics, intraoperative vasopressor administration, and length of procedure.
Inclusion Criteria: * American Society of Anesthesia classification status I-III * Ages 3 years to 17 years * Scheduled for tonsillectomy or tonsillotomy with or without adenoidectomy at Boston Children's Hospital Waltham Exclusion Criteria: * Patients not scheduled for primary tonsillectomy/tonsillotomy. * Patients with known coagulopathies * Patients with previous chronic pain syndromes * Patients with any condition/indication that would prevent them from being able to be randomized (i.e. allergy to one of the study medications)
Dexmedetomidine (1mcg/kg bolus given intravenously at induction of anesthesia
Acetaminophen (12.5mg/kg with a maximum dose of 1 gram given intravenously at induction of anesthesia).
Ketorolac 0.5mg/kg with a max dose of 30mg intravenously at the end of surgery.
Morphine (0.1mg/kg given intravenously at induction of anesthesia)
Arctuva estimate
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