Effect of intraoperative infusion of dexmedetomidine on emergence agitation among adults undergoing nasal surgeries-a prospective randomised double blind study

Context: Emergence agitation (EA) is significant in patients recovering from general anaesthesia for nasal surgery. Aim: To assess the efficacy of dexmedetomidine infusion in reducing the incidence of EA in adults undergoing nasal surgery. Settings and Design: In this prospective randomised double blind study we recruited 56 adult patients belonging to ASA 1& 2 and aged 18-60 years. Methods and Material: Group D [n=28] received a continuous infusion of dexmedetomidine at 0.4 μg/kg/hr from induction of anaesthesia until nasal packing. Group C [n=28] received a volume matched infusion of 0.9% saline. Incidence of EA was diagnosed on a score of 5 or more on the Ricker sedation agitation scale. Haemodynamic parameters, time of awakening and post-operative recovery characteristics in the perioperative period were also observed. Statistical analysis was performed using independent samples T-test, Chi-Square test or Fisher’s Exact test. Results: The incidence of EA was significantly lesser with 11(39.3%) subjects in Group D compared to 24(85.7%) subjects in Group C (p < 0.01). The mean duration of time of awakening was prolonged in group D compared to group C (11.14 min vs 5.43 min). The heart rate and mean arterial pressure were significantly lower in the study group compared to the control group (p value<0.01). The number of patients requiring rescue fentanyl in study group compared to control in Post Anaesthesia Care Unit (1 Vs 18) was significantly less. Conclusion: Dexmedetomidine infusion during nasal surgery satisfactorily reduces the incidence of EA without increasing the adverse effects.