Dexmedetomidine Infusion for Prevention of Emergence Agitation after Nasal Surgery in Adults

Background: Emergence Agitation (EA) is a clinical phenomenon occurring in the immediate postoperative period, which is characterised by agitation, hyperactivity and restlessness. EA can cause various complications ranging from physical injury to cardiac arrest. The present study aimed to analyse the effectiveness of intra-operative dexmedetomidine infusion in preventing EA among adults undergoing nasal surgery. Material and Methods: This double blind, placebo-controlled, randomised study was conducted at a tertiary care centre after obtaining institutional ethical clearance and written informed patient consent. One hundred patients who were between 20-60 years of age and who underwent elective nasal surgery under general anaesthesia were randomised into two groups. Group D (n=50) were given dexmedetomidine infusion at 0.4 mcg/kg/hr, and group C (n=50) were given a placebo (volume matched normal saline infusion). Anaesthesia was maintained with desflurane. The intraoperative haemodynamics and opioid requirements were noted. Assessment of EA (score ≥ 5) was done by using the Ricker sedation-agitation scale. Statistical analysis was done using SPSS 15.0. Results: The demographic data between the groups were comparable. Agitation score ≥ 5 among group D (4%) and group C (58%) was found to be statistically significant (P<0.05). There was no significant difference in the post-anaesthesia care unit stay duration between the two groups. Conclusion: Dexmedetomidine 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.