Listening to recorded mother’s voice versus intravenous dexmedetomidine to minimize postoperative emergence delirium in children after hypospadias repair surgeries: A prospective randomized trial

Abstract

Background: Emergence delirium (ED) is a common problem after pediatric general anesthesia. Despite being self-limited, it may be hazardous. The aim of this study was to compare listening to recorded mother’s voice versus intravenous dexmedetomidine on incidence and severity of emergence delirium after hypospadias repair surgeries. Methods: This prospective, double-blind, randomized trial included 99 children (4–9 years), who underwent hypospadias repair surgeries. Patients were randomly distributed into three equal groups: group MV (listening to recorded mother’s voice), group D (receiving dexmedetomidine), or group C (control). The primary outcomes were the incidence of ED and its severity using the pediatric anesthesia emergence delirium scale (PAED) at the post-anesthesia care unit (PACU). Results: The incidence of ED was significantly variable among the three groups (P = 0.003). The percentages were 13.3% in group MV, 6.7% in group D, and 40% in group C. Upon arrival to the PACU, the PAED score was significantly lesser in group MV versus group C (P = 0.006), and in group D versus group C (P < 0.001), However, it was comparable in group MV and group D (P = 0.478). Similar significant results were detected 10, 20, and 30 minutes after arrival to the PACU. Conclusion: This study showed that listening to the recorded mother’s voice was comparable to intravenous dexmedetomidine in decreasing the incidence and subsiding severity of emergence delirium in children after hypospadias repair surgeries. Both modalities were also helpful in minimizing preoperative anxiety. Early postoperatively, dexmedetomidine had an extra advantage related to postoperative analgesia. Clinical trials registry: ClinicalTrials.gov (NCT04941508).