Dexmedetomidine Infusion for Prevention of Emergence Agitation after Nasal Surgery

Abstract

BACKGROUNDEmergence agitation is a clinical phenomenon occurring in the immediate postoperative period characterised by agitation, hyperactivity and restlessness. It can lead to various complications ranging from mere injury to cardiac arrest. The objective of the present study was to evaluate the efficacy of intra-operative dexmedetomidine infusion in preventing emergence agitation in adults undergoing nasal surgery.METHODSAfter obtaining ethical clearance and patient consent, patients undergoing elective nasal surgery under general anaesthesia with ASA 1 and 2 between 20 to 60 years were included in this randomised placebo-control study. Sample size of 100 patients was generated with 80% power and 95% confidence interval. Group D (n=50) received dexmedetomidine infusion at a rate of 0.4 mcg/Kg/hr., from beginning of induction of anaesthesia until extubation and group C (n=50) received volume matched normal saline infusion as placebo. Anaesthesia was maintained with desflurane, and intraoperative haemodynamics and opioid requirement were noted. Ricker sedation-agitation scale was used for assessment of emergence agitation (score >= 5). Statistical analysis was conducted using SPSS 15.0.RESULTSAll demographic data were comparable between the two groups. Agitation score >= 5 was seen in 4% and 58% in group D and group C respectively, and was statistically significant (p<0.05). Time to verbal response was more in the dexmedetomidine group (6.74 +/- 2.13 min v/s 5.78 +/- 1.91 min, p<0.05); however, no statistically significant difference was noted between the two groups with respect to time to extubation, and duration of PACU stay. Intraoperative fentanyl requirement was more in group C compared to group D.CONCLUSIONSDexmedetomidine as an infusion of 0.4 mcg/Kg/hr. from induction till extubation reduces emergence agitation in adults undergoing nasal surgery under desflurane general anaesthesia. PU - JOURNAL EVOLUTION MEDICAL & DENTAL SCIENCES PI - KARNATAKA PA - C/O AKSHANTALA ENTERPRISES, NO 65, 1ST FL, SAHUKAR CHENNIAH RD, MYSORE, KARNATAKA, 570 009, INDIA